Diagnostic Value of Focused Assessment With Sonography in Trauma (FAST) and Computed Tomography in Blunt Abdominal Trauma: A Systematic Review and Meta-analysis
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Abstract
Focused Assessment with Sonography in Trauma (FAST) is a fast, widely available and affordable imaging ultrasonography (USG) protocol for detecting injuries in blunt abdominal trauma. We aimed to comprehensively evaluate the diagnostic value of FAST against Computed Tomography (CT) as the reference standard in abdominal trauma cases. Materials and methods: ystematic literature searches were conducted in PubMed, Scopus, ScienceDirect and ProQuest for studies investigating the diagnostic sensitivity and specificity of FAST ultrasound in adult blunt abdominal trauma compared to CT. Risk of bias analysis was done using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) tool. Clinical data, diagnostic tests protocol and test results were assessed. Results: Sixteen studies were included in this review, and the majority of the studies had low risk of bias. Sensitivity of FAST ranged from 46.2% to 100%, while specificity ranged from 84.6% to 100%. Pooled sensitivity and specificity were 78.2% (CI 95%: 0.758 - 0.805) and 97.8% (CI 95%: 0.975 - 0.981), respectively. The area under the curve (AUC) for overall datasets was 0.9512, indicating a high accuracy of FAST compared to the reference standard. Conclusion: FAST have moderate sensitivity and high specificity in diagnosing blunt abdominal trauma.
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