Normal view MARC view ISBD view

Guided bronchoscopy for the evaluation of pulmonary lesions: An updated meta-analysis.

MedStar author(s):

Citation: Chest. 2023 Jan 11PMID: 36640994Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2023 ISSN:

0012-3692

Name of journal: ChestAbstract: 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.All authors: Nadig TRFiscal year: FY2023 Digital Object Identifier:

https://dx.doi.org/10.1016/j.chest.2022.12.044

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	36640994	Available		36640994

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