Diagnostic accuracy of chest computed tomography for community-acquired pneumonia: A meta-analysis

Objective This work aimed to comprehensively assess the diagnostic efficacy of chest CT for identifying community-acquired pneumonia. Methods The relevant studies were retrieved from PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang databases. The retrieval time span covered all published papers since the database establishment until February 18, 2026, to identify diagnostic accuracy research regarding chest CT for CAP. Two reviewers performed the literature screening and data abstraction separately. Valid data involving four core diagnostic indicators were extracted. The QUADAS-2 scale was utilized via RevMan 5.4 to evaluate the quality of all eligible research. Stata 18.0 was employed to merge major diagnostic parameters, including sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Researchers also drew the summary ROC curve and calculated its AUC value to evaluate the general diagnostic capability. Heterogeneity among selected papers was measured by Cochran's Q test and I 2 statistic, while Egger's test was used to examine possible publication bias. Results Eight research articles involving 4732 participants were integrated. The methodological quality evaluation revealed minimal risk of bias across the majority of these trials. The combined analysis showed that chest CT achieved a pooled sensitivity of 0.84 (95%CI: 0.69-0.93) and a pooled specificity of 0.85 (95%CI: 0.71-0.93) in diagnosing CAP. Its combined positive likelihood ratio reached 5.5 (95%CI: 2.8-10.8), while the negative likelihood ratio was 0.19 (95%CI: 0.09-0.38). The overall AUC value of the synthesized ROC curve was 0.91 (95%CI: 0.88-0.93). Further statistical verification indicated that there was no significant publication bias in all included studies ( P = 0.49). Within subgroup analysis, only study design notably affected diagnostic sensitivity ( P = 0.02), whereas patient source, reference standard, and index test demonstrated no significant impacts ( P > 0.05). Conclusion Chest CT exhibits superior diagnostic precision for community-acquired pneumonia and serves as a vital diagnostic instrument. Nevertheless, owing to significant heterogeneity across the enrolled studies, this finding necessitates additional verification via more high-quality investigations.