Prehospital ultrasound scanning for abdominal free fluid detection in trauma patients: a systematic review and meta-analysis

Table 3 The grading of recommendations, assessment, development, and evaluation assessment

Question: Should Prehospital ultrasound be used to diagnose hemoperitoneum?
Outcome	№ of studies (№ of patients)	Factors that may decrease certainty of evidence					Test accuracy CoE
Outcome	№ of studies (№ of patients)	Risk of bias	Indirectness	Inconsistency	Imprecision	Publication bias	Test accuracy CoE
True positives (patients with hemoperitoneum)	6 studies 276 patients	Not serious	Not serious	Serious^a	Serious^b	Publication bias strongly suspected^c	⨁◯◯◯ Very low
False negatives (patients incorrectly classified as not having hemoperitoneum)	6 studies 276 patients	Not serious	Not serious	Serious^a	Serious^b	Publication bias strongly suspected^c	⨁◯◯◯ Very low
True negatives (patients without hemoperitoneum)	6 studies 1080 patients	Not serious	Not serious	Not serious	Not serious	None	⨁⨁⨁⨁ High
False positives (patients incorrectly classified as having hemoperitoneum)	6 studies 1080 patients	Not serious	Not serious	Not serious	Not serious	None	⨁⨁⨁⨁ High

^aHigh heterogeneity for sensitivity between studies, determined by chi-square test was 94%
^bWide confidence interval for sensitivity
^cThe funnel plot of sensitivity was asymmetrical

ISSN: 1471-227X