Diagnostic accuracy of ultrasonography for detecting gastric tube placement: an updated meta-analysis

J. Peng, M. Tang, L.-L. Liu, W.-T. Chen, Q.-H. Ye

Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China. chenweitingwl@sina.com

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• Gastroenterology
• Ultrasound

OBJECTIVE: This study aimed at reviewing the diagnostic accuracy of ultrasonography for detecting correct nasogastric tube placement compared with X-ray imaging as the reference standard.

MATERIALS AND METHODS: This was a systematic review and meta-analysis of observational studies published between 1961 and 2022. We included studies that compared the diagnostic accuracy of ultrasound detection for nasogastric tube placement with that of X-ray imaging in adult patients who were undergoing nasogastric tube placement for any reason. We searched for published studies in the following electronic databases: Cochrane Library, PubMed, EMBASE, and Web of Science. The risk of bias was assessed using a standard procedure according to the Quality Assessment of Diagnostic Accuracy Studies-2 criteria. The results were analyzed using RevMan or Meta-Disc software to determine the adequacy and conclusiveness of the available evidence.

RESULTS: Fourteen studies met our inclusion criteria. Overall, 1,812 patients were included in these studies. The results included a pooled sensitivity of 0.96 (95% confidence interval [CI] 0.94-0.97), specificity of 0.91 (95% CI 0.85-0.96), positive likelihood ratio of 5.08 (95% CI 1.49-17.39), and negative likelihood ratio of 0.08 (95% CI 0.06-0.10). This was confirmed through a summary receiver operating characteristic curve, which showed that the area under the curve was 0.96.

CONCLUSIONS: We found evidence about validity of ultrasound as an efficient method for verifying nasogastric tube placement, although there is insufficient evidence to suggest that it can be used as a diagnostic tool for incorrect gastric tube placement.

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