Summary of findings 1. Summary of Findings: Doppler trans‐thoracic echocardiography for detection of pulmonary hypertension in adults.
| Patients/population | Adults with suspected pulmonary hypertension | ||||||
| Settings | High‐prevalence settings: tertiary care hospitals including university hospitals or cardiopulmonary centres Low‐prevalence settings: preoperative examinations for liver transplantation |
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| Index test | Systolic pulmonary arterial pressure calculated from the maximum tricuspid regurgitation jet velocity by using the modified Bernoulli equation and adding right atrial pressure by Doppler trans‐thoracic echocardiography | ||||||
| Reference standard | Mean of pulmonary arterial pressure of 25 mmHg or greater assessed by right‐heart catheterisation | ||||||
| Study designs | Prospective or retrospective cohorts and cross‐sectional studies. We excluded case reports and studies of case‐control design. | ||||||
| .Findings | |||||||
| Evaluations (studies) |
No. of participants | Comfirmed PH participants | Median sensitivity (IQR) [range] |
Median specificity (IQR) [range] |
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| 17 | 3656 | 1342 | 87% (81 to 92%) [40 to 98%] |
86% (79% to 91%) [33 to 100%] |
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| Index test | Prevalence1 | No. of participants (studies) | Sensitivity (under fixed specificity of 86%)2 | Specificity (fixed) 3 | Numbers of false positives out of 1000 patients | Numbers of false negatives out of 1000 patients | Quality and Comments |
| Systolic pulmonary arterial pressure by echocardiography | 10% | 3656 (17) | 87% (95% CI 78% to 96%) | 86% | 126 | 13 | No study was assigned low risk of bias or low concern in all QUADAS‐2 domains. Poor reporting, especially in the WHO classification of PH, the index test and reference standard domains, hampered conclusive judgements about the risk of bias. |
| 58% | 59 | 75 | |||||
| 68% | 45 | 88 | |||||
| 77% | 32 | 100 | |||||
| 88% | 17 | 114 | |||||
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1Minimum, 25 percentile, 50 percentile, 75 percentile, maximum of prevalence among included studies 2HSROC (hierarchical summary receiver operating characteristic) parameters were used to illustrate sensitivity for a fixed specificity of 86% (median specificity of the included studies) 3Median specificity estimated from included studies. Abbreviations: CI: confidence interval IQR: interquartile range PH: pulmonary hypertension QUADAS‐2: a revised tool for the quality assessment of diagnostic accuracy studies WHO: World Health Organization | |||||||