Author/Authors :
Hosseini Khameneh ، Mehdi Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital - Shahid Beheshti University of Medical Sciences , Amani-Beni ، Reza School of Medicine - Isfahan University of Medical Sciences , Ahadiat ، Amirabbas Department of Bimolecular and Biomedicine - University of Girona , Kahrizi ، Mohammad Saeed ERIS Research Institute , Jafari ، Sina Department of Prosthodontics - School of Dentistry - Iran University of Medical Sciences , Seyedinnavade ، atefe ERIS Research Institute , Rafie Manzelat ، Amir Masood Accident and Emergency Department, - Southend Hospital NHS Trust , Mashatan ، Noushin School of Applied Sciences - University of Brighton , Beheshtiparvar ، Dorsa School of Medicine - Isfahan University of Medical Sciences , Moghadam Fard ، Atousa ERIS Research Institute , Lotfi ، Hamed Department of Medical Sciences - Faculty of Medicine - Birjand University of Medical Sciences , Arhami ، Hossein ERIS Research Institute , Barati ، Reza School of Medicine - Iran University of Medical Sciences , Hasanvand ، Raziyeh ERIS Research Institute , Boorboor ، Shima ERIS Research Institute , Khodaei ، Elaheh School of Medicine - Tehran University of Medical Sciences , Dadashzadehasl ، Dorsa ERIS Research Institute , Zamani ، Fatemeh Student Research Committee - Mazandaran University of Medical Sciences , Khorram ، Roya ERIS Research Institute , Ebrahimpour ، Maryam School of Medicine - Kerman University of Medical Sciences , Abdollahi ، Zeynab Department of Radiology - School of Medicine - Ahvaz Jundishapur University of Medical Sciences , Shabani ، Mohammadreza School of Biology - Islamic Azad University, Lahijan Branch , Latifi ، Nariman ERIS Research Institute , Vafadar ، Reza ERIS Research Institute , Shah Hosseini ، Sepideh ERIS Research Institute , Khodashenas ، Mehran School of medicine - Alborz University of Medical Sciences , Kazemi ، Morteza Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital - Shahid Beheshti University of Medical Sciences , Minaei Noshahr ، Reza Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital - Shahid Beheshti University of Medical Sciences , Ghayyem ، Hani School of Medicine - Shahid Beheshti University of Medical Sciences , Farahani ، Alireza ERIS Research Institute , Saeidi ، Diba Students Research Committee, Faculty of Pharmacy and Pharmaceutical Sciences - Isfahan University of Medical Sciences , Jadidi ، Sajedeh Department of Urology - Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center - Shahid Beheshti University of Medical Sciences , Goodarzy ، Babak School of Medicine - Iran University of Medical Sciences , Farrokhi ، Mehrdad ERIS Research Institute
Abstract :
Introduction: In 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. Methods: Two 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. Results: A 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). Conclusion: Our 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.
Keywords :
Child , Diagnosis , Elbow Fractures , Meta , analysis , Ultrasonography
