S1346 Exploring the Use of Point of Care Ultrasound in Screening for Non-Alcoholic Fatty Liver Disease: A Systematic Literature Review and Meta-Analysis
Notice bibliographique
Résumé
Introduction: Non-alcoholic fatty liver disease (NAFLD) is a major cause of cirrhosis and liver failure globally. It is estimated that within the next 20 years, NAFLD will be the major cause of liver-related morbidity and mortality as well as the leading indication for liver transplantation. Despite its broad impact, screening recommendations for NAFLD remain varied between gastrointestinal societies. Point of care ultrasound (POCUS) has emerged as a new cost-effective form of screening and diagnosing intrabdominal pathologies. We aimed to estimate the effectiveness of POCUS in screening for NAFLD compared to formal ultrasound when screening by general practitioners trained in ultrasonography. Methods: Data was collected from Cochrane, Pubmed, Embase, and Google Scholar using search terms related to POCUS and NAFLD screening. Observational cross-sectional studies between the years 2010-2023 were included in our analysis. Reviewers evaluated articles for eligibility and extracted data for pooled analysis. The risk of bias was assessed by reviewers using a validated risk of bias assessment tool. Discrepancies between authors were resolved by a third reviewer or by consensus. Statistical analysis included pooled sensitivity, specificity, negative predictive value, and positive predictive value with all associated 95% confidence intervals respectively. Heterogeneity between studies was plotted on a receiver operator characteristic (ROC) curve for analysis. Results: Our review included 3 studies (n = 428) that met our eligibility criteria. The cumulative sensitivity for POCUS examination was 93% (95% CI: 85 – 98%), with a negative predictive value of 99%. Additionally, the specificity of POCUS for the detection of fatty liver disease was 98% (95% CI: 96 – 99%) with a positive predictive value of 91%. Our studies were found to have low heterogeneity when evaluated on ROC curve plotting. Conclusion: Our systematic literature review supports the effectiveness of POCUS as a reliable method for screening for fatty liver disease and NAFLD when compared to formal ultrasound. The comparable diagnostic performance, high sensitivity, and specificity of POCUS in detecting hepatic steatosis make it a promising tool for early detection and intervention in NAFLD. Moreover, its portability, accessibility, and potential cost-effectiveness make POCUS a valuable screening option, particularly in resource-limited settings. Further studies are required to validate the findings of our review on POCUS as a screening method (Figure 1, Table 1).Figure 1.: Study selection flowchart. Table 1. - Overall Characteristics of the Included Studies Author Study Design Country N Average Age in Years (Range) % Male POCUS Operator Training POCUS Device Formal Ultrasound Device Barreiros et al. (2019) Cross-Sectional Germany 300 55 (18 - 96) 53% Certification with the German Society for Ultrasound in Medicine Vscan Dual Probe pocket device (GE Medical Systems, Milwaukee, WI, USA) GE Logiq E9 ultrasound system (GE Medical Systems, Milwaukee, WI, USA) Miles et al. (2019) Cross-Sectional Canada 100 53 (N/A) 55% Certification in POCUS via the Canadian Point of Care Ultrasound Society Undefined Handheld Device using a 5–1 MHz phased-array probe GE Logiq E9 ultrasound system (GE Medical Systems, Milwaukee, WI, USA) Stock et al. (2015) Cross-Sectional Germany 28 68 (29-94) 43% Board certification by the National Ultrasound Society Acuson P10 Portable Ultrasound System (Siemens Medical Solutions, Malvern, PA, USA) Sonoline Antares ultrasound system (Siemens Medical Solutions, Malvern, PA, USA)
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,018 | 0,051 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,001 |
| Méta-épidémiologie (sens large) | 0,019 | 0,032 |
| Bibliométrie | 0,009 | 0,010 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».