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Lung ultrasound is more cost-effective and safer than X-ray for diagnosing pneumonia in primary care

A study by IDIAPJGol, conducted during the first wave of the COVID-19 pandemic, suggests that implementing this diagnostic technique can reduce costs, patient travel and side effects, particularly in rural or resource-limited settings

  • 20 AUGUST 2025

A study carried out by the Clinical Ultrasound in Primary Care Research Group (GRECOCAP) at the Research Support Unit (USR) Lleida of IDIAPJGol reveals that lung ultrasound is a more useful and cost-effective tool than chest X-ray for diagnosing pneumonia caused by COVID-19 in primary care. This research, published in BMC Pulmonary Medicine, was conducted at the Balaguer Primary Care Centre during the first wave of the pandemic (between March and September 2020). A total of 212 patients with symptoms compatible with COVID-19 were included, all of whom underwent both an ultrasound and an X-ray to compare their diagnostic accuracy and economic cost.

Advantages of ultrasound

The results of the study show that the average cost of lung ultrasound was €50.56, compared to €102.42 for an X-ray. Although X-ray achieved a slightly higher positive predictive value than ultrasound (77.04 % compared with 71.28 %), the cost-effectiveness analysis indicates that each additional percentage point of effectiveness from X-ray represents an extra cost of €9.

The authors highlight that, beyond being more economical, ultrasound also offers advantages such as the absence of radiation, immediate diagnosis, and the possibility of being performed directly in the consultation room. This makes it particularly valuable in rural or low-resource areas, where access to radiology equipment is often limited.

The study argues that with adequate training for professionals and the provision of portable ultrasound devices, implementing lung ultrasound could improve early detection of pneumonia, reduce unnecessary referrals, and contribute to infection control, especially in health crisis situations such as the pandemic.

Immediate application

Although the research was carried out in a local context, the researchers consider the results to be transferable and potentially useful in guiding future health policy decisions.

José María Palacín, GRECOCAP researcher and coordinator of the study, stresses that “in a context of limited resources, we must prioritise diagnostic technologies that are accessible, efficient and safe. In this regard, lung ultrasound has proven to be the most cost-effective option for diagnosing pneumonia caused by COVID-19 and other similar conditions in primary care settings.”

Article reference

Martínez Redondo J, Comas C, Crespo Pons M, García Serrano C, Pujol Salud J, Casajuana Closas M, Ortega Bravo M, Palacín Peruga JM. Lung ultrasound is cost-effective for early diagnosis of COVID-19 pneumonia in primary care. BMC Pulm Med. 2025 Jul 2;25(1):300. doi: 10.1186/s12890-025-03753-3. PMID: 40604586; PMCID: PMC12225427.