Material and Methods:
The present review and analysis followed the PRISMA guidelines.9
Information Sources: Eligible studies were searched in MEDLINE, Embase, Ovid, Scopus, Web of Science and Journal on web databases, through EBSCO. All relevant articles were identified. Only studies obtained in full, through electronic and other search methods, were reviewed.
Search Strategy: MeSH phrases and open phrases were entered into unique search strategies.
Keywords: Key terms employed for the search: 1) Pneumothorax; 2) Chest ultrasound; 3) specificity; 4) sensitivity; 5) diagnostic accuracy; 6) ultrasonography; and 7) Chest trauma.
Boolean Operators: The Boolean operator ‘OR’ was employed to complement truncated synonyms in each search theme. The Boolean operator ‘AND’ makes up the sum of each four main search themes to specifically output papers that give at least one result for each time.
Search Limits: The search limit for literature ranged from the year 2000 up until 2020 as the concluding year, and the literature published only in the English language with full text was chosen.
Process of Study Identification: Endnote X8soft ware was used to import the search data results and remove the duplicates. Abstracts were screened for eligibility criteria, and the full text was extracted when an article was selected. Following inclusion into the review, data was extracted.
Data collection: All the titles and the extracts were screened independently by the reviewers and upon a detailed review of the full-text articles, the data were extracted and documented in a data extraction table, elaborating data items evaluated for the review.
Eligibility criteria: Studies investigating the accuracy of chest ultrasound in diagnosing pneumothorax, conforming to the diagnostic criteria of pneumothorax and met quality criteria set by QUADAS 2 was included. Data items: The data extraction table included Study ID, sample size, location, criteria of the condition, ultrasound type, machine made, and personnel involved.
Risk of bias in individual studies: QUADAS – 2 criteria evaluated risk of bias of included studies which is a tool for evaluating diagnostic accuracy10. It includes patient selection – random sequencing, index test – detection of the condition, reference evaluation – comparison with flow and timing of the study. However, if there is a non-agreement between the two reviewers for quality evaluation, the mutual agreement was reached through a discussion & consultation with a senior expert in the field.