Table 3.
Diagnostic accuracy for considering sensitivity, specificity, positive and negative Likelihood Ratio’s, Diagnostic Odds Ratio, and Area Under the Curve, for different breath sounds.
| Nr. studies | Sensitivity | Specificity | LR + | LR− | DOR | AUC | Heterogeneity Chi-square | I-square | |
|---|---|---|---|---|---|---|---|---|---|
| Abnormal, decreased or absent breath sounds | |||||||||
| All | 16 | 0.48 (0.34, 0.63) | 0.95 (0.91, 0.97) | 9.9 (4.4, 22.2) | 0.54 (0.40, 0.73) | 18 (6, 52) | 0.86 (0.83, 0.89) |
Q = 144.1 df = 2 P < 0.001 |
99 (98,99) |
| (Hemato) pneumathorax | 5 | 0.71 (0.55, 0.83) | 0.99 (0.98, 1.00) | 113.5 (30.3, 425) | 0.29 (0.18, 0.47) | 388 (104, 1449) | 0.97 (0.95, 0.98) |
Q = 2.27, df = 2, p = 0.161 |
12 (0,100) |
| Obstructive lung disease | 5 | 0.46 (0.33, 0.59) | 0.89 (0.83, 0.94) | 4.3 (2.4, 7.6) | 0.61 (0.39, 0.78) | 7 (3, 15) | 0.78 (0.74, 0.81) |
Q = 11.4, Df = 2, p = 0.002 |
82 (63, 100) |
| Pneumonia | 6 | 0.26 (0.14, 0.42) | 0.91 (0.84, 0.95) | 2.8 (1.9, 4.1) | 0.82 (0.70, 0.95) | 3 (2,5) | 0.73 (0.69, 0.76) |
Q = 132.4, df = 2, p < 0.001 |
98 (98,99) |
| Crackles | |||||||||
| All | 18 | 0.40 (0.27, 0.55) | 0.84 (0.74, 0.91) | 2.6 (1.7, 3.8) | 0.71 (0.60, 0.85) | 4 (2,6) | 0.68 (0.64, 0.72) |
Q = 1036, df = 2 p < 0.001 |
100 (100,100) |
| Congestive heart failure | 6 | 0.64 (0.50, 0.75) | 0.66 (0.45, 0.82) | 1.8 (1.1, 3.1) | 0.56 (0.39, 0.78) | 3 (2, 7) | 0.69 (0.64, 0.72) |
Q = 262.7, df=2, p < 0.001 |
99 (99,100) |
| Obstructive lung disease* | 3 | 0.14 (0.01, 0.67) | 0.89 (0.41, 0.99) | 1.3 | 0.96 | 1.4 | |||
| Pneumonia | 9 | 0.35 (0.29, 0.42) | 0.90 (0.84, 0.94) | 3.6 (2.1, 6.1) | 0.72 (0.64, 0.81) | 5 (3, 9) | 0.58 (0.53, 0.62) |
Q = 62.967, df = 2, p < 0.001 |
95 (95,99) |
| Rhonchi | |||||||||
| All | 5 | 0.23 (0.16, 0.31) | 0.87 (0.80, 0.91) | 1.7 (1.2, 2.6) | 0.89 (0.81, 0.97) | 2 (1,3) | 0.52 (0.47, 0.56) |
Q = 14.9, df =2, p < 0.001 |
87 (72,100) |
| Obstructive lung disease | Single study‡ | ||||||||
| Pneumonia | 4 | 0.25 (0.17, 0.35) | 0.85 (0.79, 0.89) | 1.6 (1.1, 2.5) | 0.89 (0.79, 1.00) | 2 (1,3) | 0.57 (0.53, 0.62) |
Q = 7.9, df=2, p = 0.01 |
75 (44, 100) |
| Wheezes | |||||||||
| All | 17 | 0.24 (0.18, 0.32) | 0.87 (0.87, 0.93) | 1.9 (1.2, 3.1) | 0.87 (0.79, 0.95) | 2 (1,4) | 0.48 (0.43, 0.52) |
Q = 132.4, df =2, p < 0.001 |
98 (98,99) |
| Congestive heart failure | 4 | 0.21 (0.18, 0.25) | 0.70 (0.63, 0.77) | 0.7 (0.5, 1.0) | 1.12 (1.00, 1.25) | 1 (0,1) | 0.23 (0.20, 0.27) |
Q = 2.6, df=2, p = 0.136 |
23 (0,100) |
| Obstructive lung disease | 10 | 0.26 (0.15, 0.41) | 0.93 (0.82, 0.97) | 3.6 (1.9, 6.8) | 0.79 (0.70, 0.90) | 5 (2,9) | 0.63 (0.58, 0.67) | Q = 110.4, df =2, p < 0.001 | 99 (97,99) |
| Pneumonia1 | 3 | 0.19 (0.09, 0.37) | 0.85 (0.72, 0.93) | 1.3 | 0.95 | 1.3 | |||
Abbreviations: LR: Likelihood Ratio; DOR: Diagnostic Odds Ratio; AUC: Area Under the Curve. *Sensitivity and specificity using xtmelogit, as Midas requires at least four studies. ‡Garcia-Pachon et al.29