Table 2.
Rate of confidence sensitivity, specificity, and likelihood ratios for physical examination signs of abdominal and pleural free fluid
| Physical examination signs | Fraction of confident, % | Diagnostic performances according to previous systematic reviews and meta-analyses [10, 11] | |||
|---|---|---|---|---|---|
| Sensitivity (95% CI) | Specificity (95% CI) | Positive LR (95% CI) | Negative LR (95% CI) | ||
| Abdominal free fluid | |||||
| Flank dullness | 66 | 0.84 (0.68–1.00) | 0.59 (0.47–0.71) | 2.0 (1.5–2.9) | 0.3 (0.1–0.7) |
| Fluid wave | 52.6 | 6.0 (3.3–11.1) | |||
| Shifting dullness | 49.2 | 0.62 (0.47–0.77) | 0.90 (0.84–9.6) | 0.4 (0.3–0.6) | |
| ‘Glaçon’ sign | 28 | 0.77 (0.60–0.88) | 0.72 (0.63–0.81) | 2.7 (1.9–3.9)- | 0.3 (0.2–0.6) |
| Pleural free fluid | |||||
| Diminished breath sounds | 90.6 | 0.42–0.88 | 0.83–0.90 | 4.3–5.2* | 0.2–0.6* |
| Dullness to percussion | 79.9 | 0.73 (0.61–0.82) | 0.91 (0.88–0.93) | 8.7 (2.2–33) | 0.3 (0.1–3.3) |
| Reduced tactile vocal fremitus | 31.6 | 0.82 | 0.86 | 5.7 (4.0–8.0) | 0.2 (0.1–0.4) |
| Asymmetric chest expansion | 25.2 | 0.74 | 0.91 | 8.1 (5.2–12.7) | 0.3 (0.2–0.5) |
| Pleural friction rub | 35.9 | 0.05 | 0.99 | 3.9 (0.8–18.7) | 1.0 (0.9–1.0) |
CI confidence interval, LR likelihood ratio.
*No pooled analysis because the data was per lung region or hemithorax, not per patient