Point-of-care ultrasound for evaluating acute dyspnoea in emergency departments: Systematic review and meta-analysis

Table 2 Studies evaluating point of care ultrasound as a standalone diagnostic tool without comparison to other imaging modalities

Ref.	Year of publication	Country of study	Study design and setting	Number of patients enrolled	summary of the patient population	Intervention used	Comparison used	Definition of outcome measured	TP	FP	TN	FN
Özkan et al[25]	2014	Turkey	Prospective cohort study	96	Patients presented with dyspnoea	Bedside LUS	NA	Accuracy of bedside USS to diagnose accuracy of dyspnoea	41	2	45	4
Sorlini et al[38]	2020	Italy	Single retrospective study	384	Patients with symptoms and signs of respiratory infection	POCUS performed at the time of admission or shortly afterwards	NA	Assess diagnostic accuracy of POCUS	264	34	63	23
Markarian et al[54]	2020	France	Multicenter prospective observational cohort study	100	Patients with acute dyspnoea	LUS	NA	Accuracy of LUS score to detect respiratory support need
Sanjan et al[45]	2019	India	Prospective observational study	73	Patients diagnosed with ARDS according to Berlin criteria	POCUS	No comparison group: The study focused on analysing lung ultrasound findings within the cohort	The utility of POCUS in the initial assessment of ARDS
Gibbons et al[39]	2021	United States	Prospective cohort study	110	patients presenting with symptoms of COVID-19	Portable LUS, CXR and CT (if abnormal)	NA	Compare test characteristics of LUS and CXR in COVID-19	79	19	10	2
Bianchi et al[40]	2021	Italy	Prospective cohort study	360	Patients with symptoms suggestive of COVID-19	POCUS by emergency physicians	NA	Analyse diagnostic power of POCUS for COVID-19	120	64	156	20
Msolli et al[14]	2021	Tunisia	Prospective observational study	700	Patients admitted for acute dyspnoea as chief complaint	LUS performed by a pair of ED residents	NA	To assess the accuracy and reproducibility of USS in CHF	325	82	247	82
Vauthier et al[46]	2021	France	Prospective diagnostic accuracy study	103	Patients presenting to the ED with acute dyspnoea	POCUS algorithm (LUS and Echo)	No comparison group	Evaluate diagnostic performance of pocus in patients with acute SOB	40	4	57	2
Altuğ et al[47]	2024	Turkey	A single-center prospective study	100	Patients with ARDS as per Berlin criteria	LUS score to investigate prognosis	No comparison group	Prognostic value of the LUS Score in ARDS patients	48	4	44	4
Patel et al[13]	2018	Pakistan	observational study	50	patients with ARDS	Bedside LUS in emergency protocol	No control group	Determine the accuracy of BLUE protocol in ARDS	45	6	194	5
Glöckne et al[48]	2020	Germany	Prospective mono-center study	102	Adult patients presenting with undifferentiated acute dyspnoea	POCUS in diagnosing AHF and monitoring the therapeutic success	Not stated	Evaluates the accuracy of POCUS in diagnosing AHF and monitoring the therapeutic success	27	1	39	22
Cibinel et al[49]	2011	Italy	Prospective study	56	Patients presented with acute dyspnoea	PLUS	Not stated	Evaluate diagnostic accuracy of PLUS to differentiate cardiogenic and non-cardiogenic causes of acute dyspnoea	25	5	24	2
Carlino et al[41]	2018	Italy	Prospective observational study	100	Patients presenting with acute dyspnoea	Integrated ultrasound examination	Not stated	To identify accuracy of an integrated ultrasound approach for diagnosis of acute heart failure	37	6	55	2
Liu et al[50]	2016	China	A prospective, single-blind trial	98 (27 with pneumonia HF)	Patients with acute dyspnoea in the ED	LUS and TTE were performed within 30 minutes	Not stated	Identify cardiogenic from infection cause of acute SOB	26	1	49	22
Ahn et al[51]	2017	South Korea	Single-center prospective observational study	308	Patients with dyspnoea, CP and symptomatic hypotension	Implementation of the SEARCH 8Es POCUS protocol	NA	POCUS ability to narrow differential diagnoses and increase physicians’ diagnostic confidence in patients with SOB, CP and hypotension	281	2	306	27
House et al[52]	2020	Nepal	Prospective cross-sectional study	280	Patients presenting with dyspnoea to the ED	LUS with pre and post scan diagnosis	NA	Changes in diagnosis and management following LUS	110	45	57	68
Farahmand et al[53]	2020	Iran	Diagnostic accuracy study	120	Patients were referred to ED with acute dyspnoea	Heart, lung and IVC USS	NA	Accuracy of USS to diagnose decompensated HF	88	89	31	32
Sforza et al[42]	2017	Italy	Diagnostic accuracy study	68	Patients presenting with acute dyspnoea to ED	Multi-organ ultrasound using a pocket-sized ultrasound device	NA	To test the usefulness and accuracy of multi-organ USS	25	8	33	2
Markarian et al[44]	2019	France	Observational single-centre study	137	Patients over age 64 admitted to the ED for acute dyspnoea with hypoxia	Early LUS by ED doctors followed by usual care	NA	Accuracy of LUS to evaluate severity of acute dyspnoea in elderly patients	40	1	93	3
Öhman et al[55]	2019	Finland	Prospective diagnostic study	100	Patients with undifferentiated dyspnoea	Cardiothoracic and LUS	NA	Accuracy of cardiothoracic and LUS in diagnosing HF	50	2	48	0
Wooten et al[43]	2019	United States	prospective observational cohort study	99	Patients presenting with dyspnoea to ED	Bedside LUS and CXR	NA	Assess accuracy of LUS and CXR in pulmonary oedema	31	7	60	1

AHF: Acute heart failure; ARDS: Acute respiratory distress syndrome; CHF: Congestive heart failure; CP: Chest pain; COVID-19: Coronavirus disease 2019; CXR: Chest X-ray; ED: Emergency department; HF: Heart failure; IVC: Inferior vena cava; IUE: Integrated ultrasound examination; LUS: Lung ultrasound; NA: Not available; POCUS: Point of care ultrasound; SOB: Shortness of breath; TTE: Transthoracic echocardiography; TS: Triple scan; USS: Ultrasound.