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Am J Emerg Med. 2019 Jun 4. pii: S0735-6757(19)30383-3. doi: 10.1016/j.ajem.2019.06.006. [Epub ahead of print]

Accuracy of point-of-care ultrasound and radiology-performed ultrasound for intussusception: A systematic review and meta-analysis.

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Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Department of Pediatrics, Driscoll Children's Hospital, Corpus Christi, TX, USA.
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Pediatric Emergency Medicine, The University of Texas at Austin School of Medicine, Austin, TX, USA.
Department of Emergency Medicine, John Peter Smith Hospital, Fort Worth, TX, USA.
Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan.
Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address:



It is unclear whether point-of-care ultrasound (POCUS) by emergency medicine physicians is as accurate as radiology-performed ultrasound (RADUS). We aim to summarize the diagnostic accuracy of ultrasonography for intussusception and to compare the performance between POCUS and RADUS.


Databases were searched from inception through February 2018 using pre-defined index terms. Peer-reviewed primary studies that investigated the diagnostic accuracy of ultrasound for intussusception in children were included. The study is reported using Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA). Meta-analysis of the diagnostic accuracy of ultrasound for intussusception was conducted using the random-effects bivariate model. Subgroup analysis (POCUS vs RADUS) was also performed. Meta-regression was utilized to determine if the diagnostic accuracy between POCUS and RADUS was significantly different.


Thirty studies (n = 5249) were included in the meta-analysis. Ultrasonography for intussusception has a sensitivity: 0.98 (95% CI: 0.96-0.98), specificity: 0.98 (95% CI: 0.95-0.99), positive likelihood ratio: 43.8 (95% CI: 18.0-106.7) and negative likelihood ratio: 0.03 (95% CI: 0.02-0.04), with an area under ROC (AUROC) curve of 0.99 (95% CI: 0.98-1.00). Meta-regression suggested no significant difference in the diagnostic accuracy for intussusception between POCUS and RADUS (AUROC: 0.95 vs 1.00, p = 0.128).


Current evidence suggested POCUS has a high diagnostic accuracy for intussusception not significantly different from that of RADUS.


Diagnostic accuracy; Intussusception; Meta-analysis; Point-of-care ultrasound


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