ISSN : 2146-3123
E-ISSN : 2146-3131

Focused Assessment with Sonography in Trauma for Assessment of Injury in Military Settings: A Meta-analysis
Xingshun Qi1,2,3,4, Jing Tian1,3, Rui Sun1, He Zhang1, Jinsong Han1, Hai Jin1, Hui Lu1,4
1Military Medical Research Group, General Hospital of Northern Theater Command Shenyang, Liaoning Province, China
2Meta-Analysis Interest Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China
3Co-first authors.
4Co-corresponding authors.
DOI : 10.4274/balkanmedj.galenos.2019.2019.8.79
Pages : 3-8

Abstract

Background: Non-invasive, rapid, and precise assessment of injury in the military settings is extremely important, yet difficult. Focused assessment with sonography in trauma (FAST) is being increasingly employed for assessing the location and severity of injury and guiding further treatment strategy. However, the evidence regarding the utility of FAST in the military settings is scattered.
Aims: To evaluate the diagnostic performance of FAST in the assessment of injury in the military settings.
Study Design: Meta-analysis.
Methods: We identified all relevant papers via the PubMed, EMBASE, and Cochrane Library databases. We evaluated the quality of included studies by the Quality Assessment of Diagnostic Accuracy Studies-2 tool. We pooled the area under the curve (AUC), sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio as the effect sizes, followed by evaluating the heterogeneity among the studies by p value and I2.
Results: Among the 39 papers, a total of six papers were included. The sample size ranged from 15 to 396. The AUC of FAST for assessing the injury was 0.85. The pooled sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio were 0.66, 0.98, 33.1, 0.34, and 97, respectively. The heterogeneity among the studies was statistically significant (p=0.006, I2=78%).
Conclusion: FAST is potentially valuable for assessing injury in the military settings. Due to its high specificity, FAST may be appropriate to rule in significant injury. However, because of its poor sensitivity, the ability of FAST to rule out injury cannot be relied upon.

Keywords : Focused assessment, injury, military medicine, trauma, ultrasound
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