Evidence map›Paper›PMID 42299435›Full record

ReviewArchives of academic emergency medicine2026

Diagnostic Accuracy of Ultrasonography for Identification of Skull Fracture in Children: A Systematic Review and Meta-analysis.

Reza Soltani Motlagh, Lida Zare Lahijan, Mehrdad Farrokhi, Khadijeh Harati, Reza Zahedpasha, Sepehr Ramezanipour, Ali Mashhadi Nezhad, Mobin Mottahedi, Helena Mehran, Atousa Moghadam Fard and 7 more

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PubMed Full text at PMC Publisher
In one paragraph

Review in Archives of academic emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

17 authors.

Reza Soltani MotlaghERIS Research Institute, Tehran, Iran.
Lida Zare LahijanBiomedical Engineering Department, Faculty of Electrical and Computer Engineering, University of Tabriz, Tabriz, Iran.
Mehrdad FarrokhiERIS Research Institute, Tehran, Iran.
Khadijeh HaratiERIS Research Institute, Tehran, Iran.
Reza ZahedpashaDepartment of Radiology, School of Medicine, 5th Azar Hospital, Golestan University of Medical Sciences, Gorgan, Golestan, Iran.
Sepehr RamezanipourERIS Research Institute, Tehran, Iran.
Ali Mashhadi NezhadDepartment of Emergency Medicine, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Mobin MottahediDepartment of Operating Room, School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran.
Helena MehranERIS Research Institute, Tehran, Iran.
Atousa Moghadam FardERIS Research Institute, Tehran, Iran.
Hamed BeiramyERIS Research Institute, Tehran, Iran.
Morteza AlipourERIS Research Institute, Tehran, Iran.
Kimia KowsariERIS Research Institute, Tehran, Iran.
Sanaz Amiri MarbiniDepartment of Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Hamed GhorbaniDepartment of Computer and Information Technology Engineering, Qazvin Branch, Islamic Azad University, Qazvin, Iran.
Fatemeh AminiWest China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
Naeimeh HosseiniHelmholtz Pioneer Campus, Helmholtz Munich, Neuherberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: There is no consensus on the diagnostic performance of ultrasonography for identifying skull fractures in children, and the accuracy of this imaging modality in this age group has been questioned. This study performed a pooled analysis to explore the diagnostic performance characteristics of ultrasonography in this regard. Methods: Three databases, Web of Science, Medline, and Scopus, were systematically searched from their inception through August 2025. Data extraction of diagnostic parameters was performed by two independent authors. Pooled estimates of the diagnostic parameters were calculated using Meta-Disc software and the MIDAS package of Stata. Results: The estimated sensitivity of ultrasonography for detecting skull fracture in children was 0.89 (95% confidence interval (CI): 0.86-0.92), and the specificity was 0.97 (95% CI: 0.96-0.98). The estimated positive likelihood ratio (PLR) was 23.21 (95% CI: 14.84-36.32), while the negative likelihood ratio (NLR) was 0.13 (95% CI: 0.09-0.20). The diagnostic odds ratio (DOR) was 208.89 (95% CI: 112.68-387.27), and the estimated overall diagnostic accuracy of ultrasonography was 0.96. Conclusion: Ultrasonography demonstrated high diagnostic accuracy for identifying skull fractures in children, with evidence indicating stronger performance for confirmation than for exclusion. However, the high risk of bias in patient selection across the studies limits the generalizability of the evidence, and the results should therefore be interpreted with appropriate caution.

Indexed as

Meta-analysisPediatricsSkull fracturesSystematic reviewTomographyUltrasonographyX-Ray Computed

Identifiers

PMID42299435
PMCPMC13265071

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