{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:27:26Z","timestamp":1789730846410,"version":"4.0.1"},"reference-count":23,"publisher":"European Respiratory Society (ERS)","issue":"178","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir Rev"],"accepted":{"date-parts":[[2025,8,22]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pneumonia remains the predominant cause of childhood mortality and morbidity globally. While various imaging modalities have been employed for paediatric pneumonia diagnosis, the diagnostic accuracy remains inadequately characterised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically evaluate and compare the diagnostic accuracy of available imaging modalities for paediatric pneumonia through both diagnostic test accuracy (DTA) meta-analyses and network meta-analysis (NMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, Cochrane Library and Web of Science were searched up to March 2025. The risk of bias was graded using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Diagnostic accuracy measures were pooled using random-effects DTA meta-analyses, while relative diagnostic performance was compared through NMAs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>81 studies published in 22 countries since 2008 were included, with a total of 34\u2009625 children. In most of the studies, there was an unclear risk of bias. When clinical examination served as reference test, lung ultrasound demonstrated high diagnostic accuracy with sensitivity of 0.91 and specificity of 0.93. NMAs showed superior overall diagnostic performance of computer-aided chest radiography compared to lung ultrasound across all indexes except specificity, where there was no difference in sensitivity or specificity between the two. Meta-regression identified study design and pneumonia type as significant modifiers of diagnostic sensitivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This comprehensive analysis provides robust evidence supporting the clinical utility of computer-aided chest radiography and lung ultrasound for paediatric pneumonia diagnosis. However, insufficient evidence precludes definitive conclusions regarding other computer-aided modalities. Future high-quality comparative studies are needed to validate these findings in diverse clinical settings and evaluate emerging imaging technologies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/16000617.0161-2025","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:30:16Z","timestamp":1765359016000},"page":"250161","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic accuracy of various imaging modalities for children with pneumonia: a systematic review and network meta-analysis"],"prefix":"10.1183","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6530-0141","authenticated-orcid":false,"given":"Feiyang","family":"Na","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2434-4743","authenticated-orcid":false,"given":"Chen","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunhang","family":"Jing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoai","family":"Ke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junlin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianli","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"2025121001300800000_34.178.250161.1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/S2352-4642(23)00030-5","article-title":"The effect of early childhood respiratory infections and pneumonia on lifelong lung function: a systematic review","volume":"7","author":"Collaro","year":"2023","journal-title":"Lancet Child Adolesc Health"},{"key":"2025121001300800000_34.178.250161.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2739"},{"key":"2025121001300800000_34.178.250161.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30925-9"},{"key":"2025121001300800000_34.178.250161.4","unstructured":"World Health Organization . Pneumonia in children. Date last updated: 11 November 2022. Date last accessed: 21 May 2025. www.who.int\/news-room\/fact-sheets\/detail\/pneumonia"},{"key":"2025121001300800000_34.178.250161.5","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1080\/17476348.2022.2099842","article-title":"Childhood pneumonia diagnostics: a narrative review","volume":"16","author":"Ojuawo","year":"2022","journal-title":"Expert Rev Respir Med"},{"key":"2025121001300800000_34.178.250161.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.9039"},{"key":"2025121001300800000_34.178.250161.7","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s13052-024-01583-3","article-title":"Comparison of lung ultrasound and chest radiography for detecting pneumonia in children: a systematic review and meta-analysis","volume":"50","author":"Yang","year":"2024","journal-title":"Ital J Pediatr"},{"key":"2025121001300800000_34.178.250161.8","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-2833"},{"key":"2025121001300800000_34.178.250161.9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/MEJ.0000000000000883","article-title":"Diagnostic accuracy of lung ultrasonography in childhood pneumonia: a meta-analysis","volume":"29","author":"Lu","year":"2022","journal-title":"Eur J Emerg Med"},{"key":"2025121001300800000_34.178.250161.10","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02810-0"},{"key":"2025121001300800000_34.178.250161.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.02.022"},{"key":"2025121001300800000_34.178.250161.12","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.19163"},{"key":"2025121001300800000_34.178.250161.13","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2385"},{"key":"2025121001300800000_34.178.250161.14","doi-asserted-by":"publisher","DOI":"10.5195\/jmla.2021.1260"},{"key":"2025121001300800000_34.178.250161.15","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"2025121001300800000_34.178.250161.16","doi-asserted-by":"publisher","DOI":"10.1059\/0003-4819-155-8-201110180-00009"},{"key":"2025121001300800000_34.178.250161.17","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.2436"},{"key":"2025121001300800000_34.178.250161.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2018.02.010"},{"key":"2025121001300800000_34.178.250161.19","doi-asserted-by":"crossref","first-page":"82","DOI":"10.5644\/ama2006-124.163","article-title":"Lung ultrasound in the diagnosis of pediatric pneumonia: are we ready for routine use?","volume":"45","author":"Roi\u0107","year":"2016","journal-title":"Acta Med Acad"},{"key":"2025121001300800000_34.178.250161.20","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.2147\/TCRM.S96222","article-title":"Lung ultrasound for the diagnosis of childhood pneumonia: a safe and accurate imaging mode","volume":"11","author":"Hendaus","year":"2015","journal-title":"Ther Clin Risk Manag"},{"key":"2025121001300800000_34.178.250161.21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0106051"},{"key":"2025121001300800000_34.178.250161.22","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s40477-018-0306-5","article-title":"Lung ultrasound in diagnosing pneumonia in childhood: a systematic review and meta-analysis","volume":"21","author":"Orso","year":"2018","journal-title":"J Ultrasound"},{"key":"2025121001300800000_34.178.250161.23","doi-asserted-by":"crossref","first-page":"3457","DOI":"10.3390\/diagnostics13223457","article-title":"Accuracy of thoracic ultrasonography for the diagnosis of pediatric pneumonia: a systematic review and meta-analysis","volume":"13","author":"Dong","year":"2023","journal-title":"Diagnostics (Basel)"}],"container-title":["European Respiratory Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/16000617.0161-2025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:30:19Z","timestamp":1765359019000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/16000617.0161-2025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":23,"journal-issue":{"issue":"178","published-online":{"date-parts":[[2025,12,10]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1183\/16000617.0161-2025"],"URL":"https:\/\/doi.org\/10.1183\/16000617.0161-2025","relation":{},"ISSN":["0905-9180","1600-0617"],"issn-type":[{"value":"0905-9180","type":"print"},{"value":"1600-0617","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}