1.

Population	Patients of any age and gender who sustained any type of blunt injury in a civilian scenario
Setting	Clinical evaluation at hospitals of any care level
Index test	Point‐of‐care sonography (POCS) as the primary imaging tool
Reference standard	Computed tomography (CT), magnetic resonance imaging (MRI), laparotomy, laparoscopy, thoracotomy, thoracoscopy, autopsy
Findings	POCS emerged as an integral part of trauma algorithms, and remains the point‐of‐care imaging tool of choice for screening for thoracoabdominal bleeding in most regions of the world. Determining the diagnostic accuracy of POCS in patients with blunt trauma may provide clinicians with valuable information on the likelihood of chest and abdominal injuries and may contribute to decision making regarding the performance of subsequent diagnostic tests.
Limitations	Methodological quality was hampered by severe under‐reporting in the included studies. We assessed risk of bias as unclear in more than half of the studies for the domains of patient selection and reference standard, and in one‐third of the studies for the index test. There was substantial heterogeneity among the results of the individual studies, which we investigated further by sources of heterogeneity (see Table 2).
No. of participants (studies)	Summary sensitivity (95% CI)	Summary specificity (95% CI)	Summary LR+ (95% CI)	Summary LR‐ (95% CI)	Positive predictive value (95% CI)	Negative predictive value (95% CI)	Consequences in a virtual cohort of 1000a
							Missed injuries	Overtreated
8635 (34)	0.74 (0.65 to 0.81)	0.96 (0.94 to 0.98)	18.5 (10.8 to 40.5)	0.27 (0.19 to 0.37)	0.88 (0.81 to 0.94)	0.90 (0.87 to 0.93)	73 (If 280 people suffer an injury through trauma, 207 will be identified as injured, and 73 will be missed.)	29 (If 720 people do not suffer an injury through trauma, 29 will be treated as though they had been injured, i.e. overtreated.)
Sensitivity analysis with a children‐only cohort
1384 (10)	0.62 (0.47 to 0.75)	0.91 (0.81 to 0.96)	6.9 (2.5 to 18.8)	0.42 (0.26 to 0.65)	0.76 (0.53 to 0.89)	0.84 (0.77 to 0.90)	118 (If 310 children suffer an injury through trauma, 192 will be identified as injured, and 118 will be missed.)	62 (If 690 children do not suffer an injury through trauma, 62 will be treated as though they had been injured, i.e. overtreated.)
aThe median prevalence was 28% for the complete study population and 31% for the children‐only cohort.

Abbreviations

CI: confidence interval
 LR+: positive likelihood ratio
 LR‐: negative likelihood ratio