Cristina Ramos-Hernández1, Maribel Botana-Rial1, Marta Núñez-Fernández1, Irene Lojo-Rodríguez1, Cecilia Mouronte-Roibas1, Ángel Salgado-Barreira2, Alberto Ruano-Raviña3,4,5, Alberto Fernández-Villar1. 1. Hospital Alvaro Cunqueiro, Department of Pneumology, Neumo Vigo I + i, Institute of Health Research Galicia South (IISGS), 36312 Vigo, Spain. 2. Methodology and Statistics Unit, Galicia Sur Health Research Institute (IISGS), 36312 Vigo, Spain. 3. Department of Preventive and Public Health, Faculty of Medicine, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain. 4. Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), 28029 Madrid, Spain. 5. Instituto de Investigaciones Sanitarias de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain.
Abstract
INTRODUCTION: There is debate as to whether lung-ultrasound (LUS) can replace lung-auscultation (LA) in the assessment of respiratory diseases. METHODOLOGY: The diagnostic validity, safety, and reliability of LA and LUS were analyzed in patients admitted in a pulmonary ward due to decompensated obstructive airway diseases, decompensated interstitial diseases, and pulmonary infections, in a prospective study. Standard formulas were used to calculate the diagnostic sensitivity, specificity, and accuracy. The interobserver agreement with respect to the LA and LUS findings was evaluated based on the Kappa coefficient (ᴋ). RESULTS: A total of 115 patients were studied. LUS was more sensitive than the LA in evaluating pulmonary infections (93.59% vs. 77.02%; p = 0.001) and more specifically in the case of decompensated obstructive airway diseases (95.6% vs. 19.10%; p = 0.001). The diagnostic accuracy of LUS was also greater in the case of pulmonary infections (75.65% vs. 60.90%; p = 0.02). The sensitivity and specificity of the combination of LA and LUS was 95.95%, 50% in pulmonary infections, 76.19%, 100% in case of decompensated obstructive airway diseases, and (100%, 88.54%) in case of interstitial diseases. (ᴋ) was 0.71 for an A-pattern, 0.73 for pathological B-lines, 0.94 for condensations, 0.89 for pleural-effusion, 0.63 for wheezes, 0.38 for rhonchi, 0.68 for fine crackles, 0.18 for coarse crackles, and 0.29 for a normal LA. CONCLUSIONS: There is a greater interobserver agreement in the interpretation of LUS-findings compared to that of LA-noises, their combined use improves diagnostic performance in all diseases examined.
INTRODUCTION: There is debate as to whether lung-ultrasound (LUS) can replace lung-auscultation (LA) in the assessment of respiratory diseases. METHODOLOGY: The diagnostic validity, safety, and reliability of LA and LUS were analyzed in patients admitted in a pulmonary ward due to decompensated obstructive airway diseases, decompensated interstitial diseases, and pulmonary infections, in a prospective study. Standard formulas were used to calculate the diagnostic sensitivity, specificity, and accuracy. The interobserver agreement with respect to the LA and LUS findings was evaluated based on the Kappa coefficient (ᴋ). RESULTS: A total of 115 patients were studied. LUS was more sensitive than the LA in evaluating pulmonary infections (93.59% vs. 77.02%; p = 0.001) and more specifically in the case of decompensated obstructive airway diseases (95.6% vs. 19.10%; p = 0.001). The diagnostic accuracy of LUS was also greater in the case of pulmonary infections (75.65% vs. 60.90%; p = 0.02). The sensitivity and specificity of the combination of LA and LUS was 95.95%, 50% in pulmonary infections, 76.19%, 100% in case of decompensated obstructive airway diseases, and (100%, 88.54%) in case of interstitial diseases. (ᴋ) was 0.71 for an A-pattern, 0.73 for pathological B-lines, 0.94 for condensations, 0.89 for pleural-effusion, 0.63 for wheezes, 0.38 for rhonchi, 0.68 for fine crackles, 0.18 for coarse crackles, and 0.29 for a normal LA. CONCLUSIONS: There is a greater interobserver agreement in the interpretation of LUS-findings compared to that of LA-noises, their combined use improves diagnostic performance in all diseases examined.
Authors: Hans Pasterkamp; Paul L P Brand; Mark Everard; Luis Garcia-Marcos; Hasse Melbye; Kostas N Priftis Journal: Eur Respir J Date: 2015-12-02 Impact factor: 16.671
Authors: Luigi Vetrugno; Giovanni Volpicelli; Federico Barbariol; Ilaria Toretti; Livia Pompei; Francesco Forfori; Giorgio Della Rocca Journal: Crit Ultrasound J Date: 2016-02-18