PT - JOURNAL ARTICLE AU - Francisco Javier Rodríguez-Contreras AU - Antonio Calvo-Cebrián AU - Juncal Díaz-Lázaro AU - Miguel Cruz-Arnés AU - Fernando León-Vázquez AU - María del Carmen Lobón-Agúndez AU - Francisco Javier Palau-Cuevas AU - Paloma Henares-García AU - Fernando Gavilán-Martínez AU - Sandra Fernández-Plaza AU - Carmelo Prieto-Zancudo TI - Lung Ultrasound Performed by Primary Care Physicians for Clinically Suspected Community-Acquired Pneumonia: A Multicenter Prospective Study AID - 10.1370/afm.2796 DP - 2022 May 01 TA - The Annals of Family Medicine PG - 227--236 VI - 20 IP - 3 4099 - http://www.annfammed.org/content/20/3/227.short 4100 - http://www.annfammed.org/content/20/3/227.full SO - Ann Fam Med2022 May 01; 20 AB - PURPOSE We investigated whether lung ultrasound (US) performed in primary care is useful and feasible for diagnosing community-acquired pneumonia (CAP) compared with chest radiography, as most previous research has been conducted in hospital settings.METHODS We undertook a prospective observational cohort study of lung US performed in 12 primary care centers. Patients aged 5 years and older with symptoms suggesting CAP were examined with lung US (by 21 family physicians and 7 primary care pediatricians) and chest radiograph on the same day. We compared lung US findings with the radiologist’s chest radiograph report as the reference standard, given that the latter is the most common imaging test performed for suspected CAP in primary care. The physicians had varied previous US experience, but all received a 5-hour lung US training program.RESULTS The study included 82 patients. Compared with chest radiography, positive lung US findings (consolidation measuring >1 cm or a focal/asymmetrical B-lines pattern) showed a sensitivity of 87.8%, a specificity of 58.5%, a positive likelihood-ratio of 2.12, and a negative likelihood-ratio of 0.21. Findings were similar regardless of the physicians’ previous US training or experience. We propose a practical algorithm whereby patients having consolidation measuring greater than 1 cm or normal findings on lung US could skip chest radiography, whereas patients with a B-lines pattern without consolidation (given its low specificity) would need chest radiography to ensure appropriate management. Lung US was generally performed in 10 minutes or less.CONCLUSION Point-of-care lung US in primary care could be useful for investigating suspected CAP (avoiding chest radiography in most cases) and is likely feasible in daily practice, as short training programs appear sufficient and little time is needed to perform the scan.