Guided bronchoscopy for the evaluation of pulmonary lesions: An updated meta-analysis.
Guided bronchoscopy for the evaluation of pulmonary lesions: An updated meta-analysis.
- 2023
BACKGROUND: Guided bronchoscopy is increasingly utilized to diagnose peripheral pulmonary lesions (PPL). A meta-analysis published in 2012 demonstrated a pooled diagnostic yield of 70%, though recent publications have documented yields as low as 40% and as high as 90%. INTERPRETATION: Despite the reported advances in bronchoscopic technology to diagnose peripheral pulmonary lesions, the diagnostic yield of guided bronchoscopy has not improved. Copyright © 2023. Published by Elsevier Inc. METHOD: A comprehensive search was performed of studies evaluating the diagnostic yield of differing bronchoscopic technologies utilized to reach PPL's. Study quality was assessed using the QUADAS-2 assessment tool. Number of lesions, type of technology utilized, overall diagnostic yield and yield by size were extracted. Adverse events were recorded. Meta-analytic techniques were used to summarize findings across all studies. RESEARCH QUESTION: Has the diagnostic yield of guided bronchoscopy in patients with peripheral pulmonary lesions improved over the past decade? RESULT: A total of 16,389 lesions from 126 studies were included. There was no significant difference in diagnostic yield prior to 2012 (39 studies, 3052 lesions; yield 70.5%) versus after 2012 (87 studies, 13,535 lesions; yield 69.2% (P>0.05). Additionally, there was no significant difference in yield when comparing different technologies. Studies with low risk of overall bias had a lower diagnostic yield than those with high risk of bias (66% versus 71%, respectively; (p = 0.018). Lesion size>2cm, presence of bronchus sign, and reports with a high prevalence of malignancy in the study population were associated with significantly higher diagnostic yield. Significant (p<0.0001) between-study heterogeneity was also noted.
English
0012-3692
10.1016/j.chest.2022.12.044 [doi] S0012-3692(23)00030-2 [pii]
IN PROCESS -- NOT YET INDEXED
MedStar Washington Hospital Center
Medicine/Pulmonary-Critical Care
Journal Article
BACKGROUND: Guided bronchoscopy is increasingly utilized to diagnose peripheral pulmonary lesions (PPL). A meta-analysis published in 2012 demonstrated a pooled diagnostic yield of 70%, though recent publications have documented yields as low as 40% and as high as 90%. INTERPRETATION: Despite the reported advances in bronchoscopic technology to diagnose peripheral pulmonary lesions, the diagnostic yield of guided bronchoscopy has not improved. Copyright © 2023. Published by Elsevier Inc. METHOD: A comprehensive search was performed of studies evaluating the diagnostic yield of differing bronchoscopic technologies utilized to reach PPL's. Study quality was assessed using the QUADAS-2 assessment tool. Number of lesions, type of technology utilized, overall diagnostic yield and yield by size were extracted. Adverse events were recorded. Meta-analytic techniques were used to summarize findings across all studies. RESEARCH QUESTION: Has the diagnostic yield of guided bronchoscopy in patients with peripheral pulmonary lesions improved over the past decade? RESULT: A total of 16,389 lesions from 126 studies were included. There was no significant difference in diagnostic yield prior to 2012 (39 studies, 3052 lesions; yield 70.5%) versus after 2012 (87 studies, 13,535 lesions; yield 69.2% (P>0.05). Additionally, there was no significant difference in yield when comparing different technologies. Studies with low risk of overall bias had a lower diagnostic yield than those with high risk of bias (66% versus 71%, respectively; (p = 0.018). Lesion size>2cm, presence of bronchus sign, and reports with a high prevalence of malignancy in the study population were associated with significantly higher diagnostic yield. Significant (p<0.0001) between-study heterogeneity was also noted.
English
0012-3692
10.1016/j.chest.2022.12.044 [doi] S0012-3692(23)00030-2 [pii]
IN PROCESS -- NOT YET INDEXED
MedStar Washington Hospital Center
Medicine/Pulmonary-Critical Care
Journal Article