Lung Ultrasound for Community-acquired Pneumonia Diagnosis in Emergency Medicine

Study Overview
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Brief Summary
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Community-acquired pneumonia (CAP) is frequently suspected in the Emergency Department (ED). However, usual diagnosis procedure based on clinical features and chest X-Ray has rather bad performances. A recent study on CT performance in suspected CAP found that 58% of classifications were modified by CT when compared with usual procedure. However, extended CT usage in CAP diagnosis is associated with many limitations : availability in a majority of ED, delay, cost and irradiation, in particular In young patients. Lung Ultrasound (LUS) has good performances in CAP diagnosis even when compared with CT. It is a rapid, inexpensive, radiation-free tool available in a majority of ED. It is performed at the patient's bedside with immediate results. The learning curve allows Emergency Physicians (EP) to perform this exam after a relative brief training. The Investigators aim to investigate LUS performances in clinically suspected CAP authentication , and assesses specific diagnostic contributions and impact on antibiotic prescriptions .

Detailed Description
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120 patients will be enrolled on CAP suspicion. All explorations (radiography…) and biological exams (blood culture…) will be performed as usual to build physician primary diagnosis. Complementarily, an EP will be realized and final diagnosis will be made by physician. Finally, at Day28 expert adjudication committee will authentic diagnosis considering explorations and clinical issues. Frequency of discordant diagnosis between 1st and 2nd assessment and against expert will be measured Primary Purpose: diagnostic Study Phase: Not Applicable Intervention Model: NA Number of Arms: 1 Masking: open label, Masked Roles: NA Allocation: NA Study Endpoint Classification: efficacy Enrollment: 120 subjects (anticipated )

Official Title
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Lung Ultrasound for Community-acquired Pneumonia Diagnosis in Emergency Medicine

Conditions
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Community Acquired Pneumonia

Intervention / Treatment
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* Other: no intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria : - clinical suspicion of PAC Exclusion Criteria : documented end-of-life pregnancy seriously ill patients

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: no intervention|Non applicable|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of PAC classification modification (definite, probable, possible, excluded) after LUS realization | 95% confidence interval of CAP classification modification frequency before and after LUS realization | Day 0 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Concordancy of CAP classification diagnosis concordancy ( after LUS) compared to adjudication committee | CAP classification (definite, probable, possible, excluded) and kappa coefficient. | 28 days after enrollment | 
| Frequency of Antibiotic prescription modification after LUS | 95% confidence interval of antibiotic prescription intention frequency | Day 0 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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diagnosis, Point-of-Care-Ultrasound, lung ultrasound