Eleven studies (2,000 participants) were included.
The validity assessment, using the grading scheme, indicated that none of the studies were of a high quality. Three studies were of good quality and 8 studies presented weak evidence.
Four studies reported results for the ultrasound detection of free intraperitoneal fluid. The sensitivity ranged from 87% (specificity 100%) to 98% (specificity 99 and 100%) and the specificity from 99% (sensitivity 98%) to 100% (sensitivity 87 and 98%), based on 3 studies.
Ultrasonography as a screening test for intraperitoneal organ injury was reported in 5 studies. The sensitivities ranged from 69% (specificity 99%) to 96% (specificity 95%) and the specificities from 95% (sensitivity 92 and 96%) to 100% (sensitivity 83%). Variations were thought to reflect the different patient co-morbidities and diagnostic protocols used.
Four studies assessed the effectiveness of ultrasound in determining the need for emergency laparotomy. These reported sensitivities ranging from 84% (specificity 88%) to 93% (specificity 100%) and specificities from 88% (sensitivity 84%) to 100% (sensitivity 93%).
The effectiveness of ultrasound localisation of injured organs was examined in 3 studies. The sensitivities ranged from 20 to 80%, depending upon the organ injured.
The review found no studies reporting therapeutic effect or patient outcome determinations.
The relationship between operator training and the diagnostic performance of ultrasound could not be adequately investigated, given the differences in study population characteristics and design.