Diagnostic Accuracy of Ultrasonography for Identification of Elbow Fractures in Children; a Systematic Review and Meta-analysis

IntroductionIn spite of the results of previous studies regarding the benefits of ultrasonography for diagnosis of elbow fractures in children, the exact accuracy of this imaging modality is still under debate. Therefore, in this diagnostic systematic review and meta-analysis, we aimed to investigat...

Full description

Saved in:

Bibliographic Details
Published in:	Archives of academic emergency medicine Vol. 11; no. 1; p. e62
Main Authors:	Hosseini Khameneh, Seyed Mehdi, Amani-Beni, Reza, Ahadiat, Seyed-Amirabbas, Kahrizi, Mohammad Saeed, Jafari, Sina, Seyedinnavade, Seyedehatefe, Rafie Manzelat, Amir Masood, Mashatan, Noushin, Beheshtiparvar, Dorsa, Moghadam Fard, Atousa, Lotfi, Hamed, Arhami, Hossein, Barati, Reza, Hasanvand, Raziyeh, Boorboor, Shima, Khodaei, Elaheh, Dadashzadehasl, Dorsa, Zamani, Fatemeh, Khorram, Roya, Ebrahimpour, Maryam, Abdollahi, Zeynab, Shabani, Mohammadreza, Latifi, Nariman, Vafadar, Reza, Shah Hosseini, Sepideh, Khodashenas, Mehran, Kazemi, Seyyed Morteza, Minaei Noshahr, Reza, Ghayyem, Hani, Farahani, Alireza, Saeidi, Diba, Jadidi, Sajedeh, Goodarzy, Babak, Farrokhi, Mehrdad
Format:	Journal Article
Language:	English
Published:	Tehran, Iran Shahid Beheshti University of Medical Sciences 01-01-2023
Subjects:	Diagnosis Elbow Fractures Meta-analysis Review Ultrasonography
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	IntroductionIn spite of the results of previous studies regarding the benefits of ultrasonography for diagnosis of elbow fractures in children, the exact accuracy of this imaging modality is still under debate. Therefore, in this diagnostic systematic review and meta-analysis, we aimed to investigate the accuracy of ultrasonography in this regard. MethodsTwo independent reviewers performed systematic search in Web of Science, Embase, PubMed, Cochrane, and Scopus for studies published from inception of these databases to May 2023. Quality assessment of the included studies was performed using Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). Meta-Disc software version 1.4 and Stata statistical software package version 17.0 were used for statistical analysis. ResultsA total of 648 studies with 1000 patients were included in the meta-analysis. The pooled sensitivity and specificity were 0.95 (95% CI: 0.93-0.97) and 0.87 (95% CI: 0.84-0.90), respectively. Pooled positive likelihood ratio (PLR) was 6.71 (95% CI: 3.86-11.67), negative likelihood ratio (NLR) was 0.09 (95% CI: 0.03-0.22), and pooled diagnostic odds ratio (DOR) of ultrasonography in detection of elbow fracture in children was 89.85 (95% CI: 31.56-255.8). The area under the summary receiver operating characteristic (ROC) curve for accuracy of ultrasonography in this regard was 0.93. Egger's and Begg's analyses showed that there is no significant publication bias (P=0.11 and P=0.29, respectively). ConclusionOur meta-analysis revealed that ultrasonography is a relatively promising diagnostic imaging modality for identification of elbow fractures in children. However, clinicians employing ultrasonography for diagnosis of elbow fractures should be aware that studies included in this meta-analysis had limitations regarding methodological quality and are subject to risk of bias. Future high-quality studies with standardization of ultrasonography examination protocol are required to thoroughly validate ultrasonography for elbow fractures.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	2645-4904
DOI:	10.22037/aaem.v11i1.2078