Evidence map›Paper›PMID 25802560›Full record

ArticleWorld journal of emergency medicine2015

Ultrasound diagnosis of malaria: examination of the spleen, liver, and optic nerve sheath diameter.

Yuanting Zha, Michelle Zhou, Anjali Hari, Bradley Jacobsen, Neha Mitragotri, Bianca Rivas, Olga Gabriela Ventura, Janice Boughton, John Christian Fox

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In one paragraph

Article in World journal of emergency medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Yuanting ZhaIrvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA.
Michelle ZhouIrvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA.
Anjali HariIrvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA.
Bradley JacobsenIrvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA.
Neha MitragotriIrvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA.
Bianca RivasIrvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA.
Olga Gabriela VenturaIrvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA.
Janice BoughtonGritman Medical Center, 700 S Main Street, Moscow, ID, 83843, USA.
John Christian FoxIrvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA ; Department of Emergency Medicine, Irvine Medical Center, University of California, 101 The City Drive, Orange, CA, 92868, USA.
University of California, Irvine · USGritman Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOver 90% of all cases of malaria worldwide occur in Africa. Current methods of diagnosis are time and labor intensive, and could lead to delayed treatment.

methodsIn this study we investigated the effectiveness of measurements of spleen, liver, and optic nerve sheath diameter (ONSD) in identifying patients with malaria or severe malaria through the use of hand-held ultrasound devices. We recruited 40 adult patients with malaria and 16 adult control subjects at two hospitals in Mwanza, Tanzania. Ultrasonographic diagnosis was compared with rapid antigen diagnostic test and peripheral blood smear as the gold standards. An receiver operating characteristic curve test was performed to determine the most optimal diagnostic threshold for malaria and severe malaria, using each of the measurements for liver size, spleen size, and ONSD. The thresholds were determined to be >12 cm for spleen length and >15.1 cm for liver length, whereas ONSD was not significant in this study.

resultsThe sensitivities for malaria diagnosis were 66.7% and 58.3% for liver and spleen length respectively, suggesting that these measurements may not be suitable for identifying patients with severe malaria. However, the high specificity of 90.9% for spleen length and the acceptable specificity of 75.0% for liver length suggest that these measurements can be used as a method to eliminate false-positive diagnoses (i.e. patients who do not have severe malaria but are classified as having it by a test with a high sensitivity), giving a high positive predictive value.

conclusionsWe report a high specificity for spleen size and a moderate specificity for liver size in the ultrasonographic diagnosis of severe malaria. Thus when paired with a highly sensitive method of malaria diagnosis, ultrasonographic measurement of spleen and liver size is promising as part of a diagnostic algorithm for malaria. It could be used to stratify risk in patients diagnosed with malaria and assist in their triage. If no sensitive tests are available, ultrasound might be useful to suggest malaria as a cause of a patient's constellation of clinical symptoms.

Indexed as

Diagnostic ultrasoundInternational healthMalariaSub-Saharan AfricaTanzania

Identifiers

PMID25802560
PMCPMC4369524
OpenAlexW2101933451

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.