{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:07:46Z","timestamp":1788232066354,"version":"build-2803163510"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1173","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"institutional review board"},{"DOI":"10.13039\/501100005918","name":"Christian Medical College, Vellore","doi-asserted-by":"publisher","award":["IRB Minute no. - 9820"],"award-info":[{"award-number":["IRB Minute no. - 9820"]}],"id":[{"id":"10.13039\/501100005918","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study determines the diagnostic utility of lung ultrasonography (LUS) in a medical ward in a developing country. In a low resource country like India, we hope that use of lung ultrasound in primary and secondary hospitals will assist in earlier and better bedside diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective diagnostic study was done to test the diagnostic accuracy of LUS against a composite reference standard, which included clinical history and examination, basic laboratory investigations, imaging and the diagnosis at discharge. We evaluated 321 consecutive patients, admitted in our medical wards with an LUS within 24 hours of the chest radiograph being done.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Between August 2016 and August 2017, we enrolled 321 patients. The sensitivity and specificity of the LUS for all pathologies were found to be 82.5% (76.50 to 87.20) and 78.2% (69.09 to 85.26) respectively. A subgroup analysis including the patients in whom CT was part of the composite reference standard showed sensitivity and specificity of 87.9% and 92.9% for all lung pathologies. It was found that there was superior sensitivity and specificity of LUS compared with chest radiograph in a subgroup analysis of pulmonary oedema and acute respiratory distress syndrome (ARDS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>We found that the LUS was better than chest radiograph and as good as CT in most pathologies, especially pulmonary oedema and ARDS. We believe that training in the basics of bedside LUS must be part of the medical curriculum and a low-cost ultrasound machine must be made available in medical wards, so that clinical diagnosis can be supplemented with this tool. In a low resource setting like India, where access to chest radiograph and CT may be difficult particularly in a rural setup, expertise in LUS would be helpful in easy bedside diagnosis and saving cost on a CT scan.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/pmj-2021-141343","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T17:20:16Z","timestamp":1663176016000},"page":"724-730","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Bedside lung ultrasonography: comparison with chest radiography (BLUR), a diagnostic study in a developing country"],"prefix":"10.1093","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9707-1988","authenticated-orcid":false,"given":"Manisha","family":"Arthur","sequence":"first","affiliation":[{"name":"Department of General Medicine , , Chennai, Tamilnadu , India"},{"name":"Sri Ramachandra Institute of Higher Education and Research , , Chennai, Tamilnadu , India"},{"name":"Department of General Medicine , , Vellore, Tamilnadu , India"},{"name":"Christian Medical College and Hospital , , Vellore, Tamilnadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kishore","family":"Pichamuthu","sequence":"additional","affiliation":[{"name":"Department of Critical Care , , Vellore, Tamil Nadu , India"},{"name":"Christian Medical College and Hospital Vellore , , Vellore, Tamil Nadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay Prakash","family":"Turaka","sequence":"additional","affiliation":[{"name":"Department of General Medicine , , Vellore, Tamilnadu , India"},{"name":"Christian Medical College and Hospital , , Vellore, Tamilnadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tharani","family":"Putta","sequence":"additional","affiliation":[{"name":"Department of Radiology , , Vellore, Tamil Nadu , India"},{"name":"Christian Medical College and Hospital Vellore , , Vellore, Tamil Nadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Sadiq","family":"Jeeyavudeen","sequence":"additional","affiliation":[{"name":"Department of General Medicine , , Vellore, Tamilnadu , India"},{"name":"Christian Medical College and Hospital , , Vellore, Tamilnadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Zachariah","sequence":"additional","affiliation":[{"name":"Department of General Medicine , , Vellore, Tamilnadu , India"},{"name":"Christian Medical College and Hospital , , Vellore, Tamilnadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sowmya","family":"Sathyendra","sequence":"additional","affiliation":[{"name":"Department of General Medicine , , Vellore, Tamilnadu , India"},{"name":"Christian Medical College and Hospital , , Vellore, Tamilnadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel George","family":"Hansdak","sequence":"additional","affiliation":[{"name":"Department of General Medicine , , Vellore, Tamilnadu , India"},{"name":"Christian Medical College and Hospital , , Vellore, Tamilnadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramya","family":"Iyadurai","sequence":"additional","affiliation":[{"name":"Department of General Medicine , , Vellore, Tamilnadu , India"},{"name":"Christian Medical College and Hospital , , Vellore, Tamilnadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reka","family":"Karuppusami","sequence":"additional","affiliation":[{"name":"Department of Biostatistics , , Vellore, Tamil Nadu , India"},{"name":"Christian Medical College and Hospital Vellore , , Vellore, Tamil Nadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7283-7836","authenticated-orcid":false,"given":"Thambu David","family":"Sudarsanam","sequence":"additional","affiliation":[{"name":"Department of General Medicine , , Vellore, Tamilnadu , India"},{"name":"Christian Medical College and Hospital , , Vellore, Tamilnadu , India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"2023063014164997900_R1","doi-asserted-by":"crossref","DOI":"10.1186\/1757-7241-21-S2-A21","article-title":"Diagnostic performance of chest X-ray for the diagnosis of community acquired pneumonia in acute admitted patients with respiratory symptoms","volume":"21","author":"Laursen","year":"2013","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"2023063014164997900_R2","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1007\/s00134-011-2317-y","article-title":"Lung ultrasound in critically ill patients: comparison with bedside chest radiography","volume":"37","author":"Xirouchaki","year":"2011","journal-title":"Intensive Care Med"},{"key":"2023063014164997900_R3","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1186\/cc5668","article-title":"Clinical review: bedside lung ultrasound in critical care practice","volume":"11","author":"Bouhemad","year":"2007","journal-title":"Crit Care"},{"key":"2023063014164997900_R4","doi-asserted-by":"crossref","DOI":"10.4103\/JMU.JMU_77_20","article-title":"Evaluation of carotid flow time to assess fluid responsiveness in the emergency department","volume":"29","author":"Judson","year":"2021","journal-title":"J Med Ultrasound"},{"key":"2023063014164997900_R5","first-page":"1","article-title":"Screening performance characteristic of ultrasonography and radiography in detection of pleural effusion; a meta-analysis","volume":"4","author":"Yousefifard","year":"2016","journal-title":"Emerg"},{"key":"2023063014164997900_R6","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1016\/j.mayocp.2016.08.023","article-title":"Point-of-care ultrasonography for primary care physicians and general internists","volume":"91","author":"Bhagra","year":"2016","journal-title":"Mayo Clin Proc"},{"key":"2023063014164997900_R7","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s00134-015-4102-9","article-title":"Lung ultrasound training: curriculum implementation and learning trajectory among respiratory therapists","volume":"42","author":"See","year":"2016","journal-title":"Intensive Care Med"},{"key":"2023063014164997900_R8","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1111\/acem.12651","article-title":"Comparison of expert and novice sonographers' performance in focused lung ultrasonography in dyspnea (fluid) to diagnose patients with acute heart failure syndrome","volume":"22","author":"Chiem","year":"2015","journal-title":"Acad Emerg Med"},{"key":"2023063014164997900_R9","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.ajem.2013.10.003","article-title":"Performance comparison of lung ultrasound and chest X-ray for the diagnosis of pneumonia in the ED","volume":"32","author":"Bourcier","year":"2014","journal-title":"Am J Emerg Med"},{"key":"2023063014164997900_R10","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1007\/s11739-015-1297-2","article-title":"Lung ultrasound for diagnosis of pneumonia in emergency department","volume":"10","author":"Pagano","year":"2015","journal-title":"Intern Emerg Med"},{"key":"2023063014164997900_R11","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1378\/chest.10-0435","article-title":"Can chest ultrasonography replace standard chest radiography for evaluation of acute dyspnea in the ED?","volume":"139","author":"Zanobetti","year":"2011","journal-title":"Chest"},{"key":"2023063014164997900_R12","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.ajem.2008.03.009","article-title":"Evaluation of lung ultrasound for the diagnosis of pneumonia in the ED","volume":"27","author":"Parlamento","year":"2009","journal-title":"Am J Emerg Med"},{"key":"2023063014164997900_R13","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1007\/s00134-003-2075-6","article-title":"Ultrasound diagnosis of alveolar consolidation in the critically ill","volume":"30","author":"Lichtenstein","year":"2004","journal-title":"Intensive Care Med"},{"key":"2023063014164997900_R14","article-title":"Stard 2015: an updated list of essential items for reporting diagnostic accuracy studies","volume":"351","author":"Bossuyt","year":"2015","journal-title":"BMJ"},{"key":"2023063014164997900_R15","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1378\/chest.07-2800","article-title":"Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the blue protocol","volume":"134","author":"Lichtenstein","year":"2008","journal-title":"Chest"},{"key":"2023063014164997900_R16","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1590\/S1806-37132015000100008","article-title":"Diagnostic accuracy of the bedside lung ultrasound in emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients","volume":"41","author":"Dexheimer Neto","year":"2015","journal-title":"J Bras Pneumol"},{"key":"2023063014164997900_R17","article-title":"Diagnostic Test Calculator [Internet]"},{"key":"2023063014164997900_R18","article-title":"Kappa [Internet]"},{"key":"2023063014164997900_R19","doi-asserted-by":"crossref","DOI":"10.1186\/s13089-017-0059-y","article-title":"Systematic review and meta-analysis for the use of ultrasound versus radiology in diagnosing of pneumonia","volume":"9","author":"Alzahrani","year":"2017","journal-title":"Crit Ultrasound J"},{"key":"2023063014164997900_R20","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1111\/acem.12435","article-title":"Point-of-are ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis","volume":"21","author":"Al Deeb","year":"2014","journal-title":"Acad Emerg Med"},{"key":"2023063014164997900_R21","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1177\/1474515114547651","article-title":"Feasibility and reliability of pocket-size ultrasound examinations of the pleural cavities and vena cava inferior performed by nurses in an outpatient heart failure clinic","volume":"14","author":"Dalen","year":"2015","journal-title":"Eur J Cardiovasc Nurs"},{"key":"2023063014164997900_R22","doi-asserted-by":"crossref","first-page":"61","DOI":"10.3390\/diagnostics9020061","article-title":"Hand-Held ultrasound devices compared with High-End ultrasound systems: a systematic review","volume":"9","author":"Rykkje","year":"2019","journal-title":"Diagnostics"},{"key":"2023063014164997900_R23","doi-asserted-by":"crossref","DOI":"10.7326\/0003-4819-155-8-201110180-00009","article-title":"QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies","volume":"155","author":"Whiting","year":"2011","journal-title":"Ann Intern Med"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/99\/1173\/724\/50753530\/pmj-2021-141343.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/99\/1173\/724\/50753530\/pmj-2021-141343.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T14:35:16Z","timestamp":1688135716000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/99\/1173\/724\/7146669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,14]]},"references-count":23,"journal-issue":{"issue":"1173","published-online":{"date-parts":[[2022,9,14]]},"published-print":{"date-parts":[[2023,6,30]]}},"URL":"https:\/\/doi.org\/10.1136\/pmj-2021-141343","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,7]]},"published":{"date-parts":[[2022,9,14]]}}}