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Subject Area

Pediatrics

Article Type

Erratum

Abstract

In their interesting study, Elmashad et al. compared chest ultrasonography (CUS) with chest radiography (CXR) in the diagnosis of Egyptian children with pneumonia. They found that CUS detected consolidation in more than one lobe than CXR, which was statistically significant (P = 0.048). They also found that CUS compared with CXR offered an important contribution to the diagnostic panels of pediatric pleuropulmonary disorders, such as pneumonia and pleural effusion, with higher diagnostic accuracy (94.4 vs 86.7%), sensitivity (95.6 vs 88.9%), specificity (93.3 vs 86.7%), and positive predictive value (97.7 vs 95.2%). I presume that these results ought to be exercised cautiously owing to the presence of the following methodological limitation. It is obvious that in the comparative studies, an agreement between different diagnostic tools must be studied with special regard to a reliable reference standard. In the study methodology, Elmashad et al. made a comparison between CUS and CXR in detecting pneumonia in the studied cohort without mentioning the exact reference standard of diagnosing pneumonia. Interestingly, systematic review and meta‑analysis recruiting diagnostic studies about CUS to predict pneumonia in pediatric patients showed that no agreement on reference standard to diagnose pneumonia was found: nine studies used CXR, four studies considered the clinical diagnosis, and only one study used computed tomography. It was concluded that the high heterogeneity noticed across individual studies, and the absence of a reliable reference standard rendered the promising effect of CUS in diagnosing pediatric pneumonia questionable. I, therefore, assume that more methodologically rigorous, large‑scale studies are needed before the final recommendation of CUS as a preferred imaging tool in the diagnostic algorithm of pneumonia in Egyptian children.

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