title: Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis.
abstract: OBJECTIVE
  This study compares, by meta-analysis, the use of anterior-posterior chest radiography (CR) with transthoracic ultrasonography for the diagnosis of pneumothorax.
  
  
  METHODS
  English-language articles on the performance of CR and ultrasonography in the diagnosis of a pneumothorax were selected. In eligible studies, data were recalculated, and the forest plots and summary receiver operating characteristic (sROC) curves were analyzed.
  
  
  RESULTS
  Pooled sensitivity and specificity were 0.88 and 0.99, respectively, for ultrasonography, and 0.52 and 1.00, respectively, for CR. For ultrasonography performed by clinicians other than radiologists, pooled sensitivity and specificity were 0.89 and 0.99, respectively. The sROC areas under the curve were compared, and no significant differences between ultrasonography and CR were found. Meta-regression analysis implied that the operator is strongly associated with accuracy (relative diagnostic OR, 0.21; 95% CI, 0.05-0.96; P = .0455).
  
  
  CONCLUSIONS
  The meta-analysis indicated that bedside ultrasonography performed by clinicians had higher sensitivity and similar specificity compared with CR in the diagnosis of pneumothorax, but the accuracy of ultrasonography in the diagnosis of pneumothorax depended on the skill of the operators.
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University, School of Medicine and Research Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Wu
authors.initials: W
authors.lastname: Ding
authors.affiliation: Department of Burns, Second Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Yuehong
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University, School of Medicine and Research Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Jianxin
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University, School of Medicine and Research Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University, School of Medicine and Research Institute of Emergency Medicine, Zhejiang University, Hangzhou, China. Electronic address: zmhz@hotmail.com.
authors.forename: Mao
authors.initials: M
authors.lastname: Zhang
mesh_terms: D006801:Humans; D011030:Pneumothorax / Q000000981:diagnostic imaging*; D012372:ROC Curve; D013902:Radiography, Thoracic; D012680:Sensitivity and Specificity; D014463:Ultrasonography