Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting

Amatya, Yogendra; Rupp, Jordan; Russell, Frances M.; Saunders, Jason; Bales, Brian; House, Darlene R.

doi:10.1186/s12245-018-0170-2

Cited by 137Ultrasound in Clinical ApplicationsPneumonia and Respiratory InfectionsVenous Thromboembolism Diagnosis and Management

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Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting

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Amatya, Yogendra, Rupp, Jordan, Russell, Frances M., Saunders, Jason, Bales, Brian, House, Darlene R.·2018·International Journal of Emergency Medicine

DOI 10.1186/s12245-018-0170-2PMC PMC5845910

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Abstract

BACKGROUND: Lung ultrasound is an effective tool for diagnosing pneumonia in developed countries. Diagnostic accuracy in resource-limited countries where pneumonia is the leading cause of death is unknown. The objective of this study was to evaluate the sensitivity of bedside lung ultrasound compared to chest X-ray for pneumonia in adults presenting for emergency care in a low-income country. METHODS: Patients presenting to the emergency department with suspected pneumonia were evaluated with bedside lung ultrasound, single posterioranterior chest radiograph, and computed tomography (CT). Using CT as the gold standard, the sensitivity of lung ultrasound was compared to chest X-ray for the diagnosis of pneumonia using McNemar's test for paired samples. Diagnostic characteristics for each test were calculated. RESULTS: Of 62 patients included in the study, 44 (71%) were diagnosed with pneumonia by CT. Lung ultrasound demonstrated a sensitivity of 91% compared to chest X-ray which had a sensitivity of 73% (p = 0.01). Specificity of lung ultrasound and chest X-ray were 61 and 50% respectively. CONCLUSIONS: Bedside lung ultrasound demonstrated better sensitivity than chest X-ray for the diagnosis of pneumonia in Nepal. TRIAL REGISTRATION: ClinicalTrials.gov, registration number NCT02949141 . Registered 31 October 2016.

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In resource-limited settings, lung ultrasound was more sensitive and specific than chest radiograph to diagnose pneumonia.
“In resource-limited settings, lung ultrasound was more sensitive and specific than chest radiograph to diagnose pneumonia (44).”
From Tele-Ultrasound in Resource-Limited Settings: A Systematic Review (2019) · cites this paper as [44]
The Results report that lung ultrasound was significantly more sensitive than chest X-ray for diagnosing pneumonia (91% versus 73%, p = 0.01). Although its measured specificity was numerically higher (61% versus 50%), the difference was not significant (p = 0.62), and the paper describes the specificities as similar. The claim overstates the specificity finding. (LLM, conf=0.88)
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Bedside lung ultrasound for the diagnosis of pneumonia in children presenting to an emergency department in a resource-limited setting
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Performance comparison of lung ultrasound and chest x-ray for the diagnosis of pneumonia in the ED
Bourcier, J.-E., Paquet, J., Seinger, M., Gallard, E., Redonnet, J.-P., Chedaddi, F., Garnier, D., Bourgeois, J., & Geeraerts, T. (2013) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2013.10.003 · Cited by 176

Authors: Amatya, Y., Rupp, J., Russell, F. M., Saunders, J., Bales, B., & House, D. R.
Affiliations: Patan Academy of Health Sciences (NP)
Vanderbilt University Medical Center (US)
Indiana University School of Medicine (US)
Corresponding author: House, Darlene R.
ORCID: Rupp, Jordan
Russell, Frances M.
House, Darlene R.
Venue: International Journal of Emergency Medicine
Publisher: Springer Science and Business Media LLC
Published: 2018-03-12
Volume: 11
Issue: 1
Pages: 8-8
ISSN: 1865-1372 (ISSN-L)
1865-1380
DOI: 10.1186/s12245-018-0170-2
PMC: PMC5845910
OpenAlex: W2802130527
Cited by: 137
References: 25
Citations by year: 2026: 4 · 2025: 17 · 2024: 14 · 2023: 20 · 2022: 22 · 2021: 30 · 2020: 17 · 2019: 8 · 2018: 5
FWCI: 12.57
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
Locations: International Journal of Emergency Medicine (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics: Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Ultrasound in Clinical Applications
Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
Keywords: lung ultrasound, pneumonia diagnosis, chest radiograph, diagnostic accuracy, sensitivity, resource-limited settings, emergency department, computed tomography, low-income countries, Nepal

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Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting

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