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When Pulmonologists Are Novice to Navigational Bronchoscopy, What Predicts Diagnostic Yield?

Predicting factors of diagnostic yield in electromagnetic navigation bronchoscopy (ENB) have been explored in a number of previous studies based on data from experienced operators. However, little is known about predicting factors when the procedure is carried out by operators in the beginning of th...

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Autores principales: Toennesen, Louise L., Vindum, Helene H., Risom, Ellen, Pulga, Alexis, Nessar, Rafi M., Arshad, Arman, Christophersen, Alice, Park, Yoon Soo, Cold, Kristoffer Mazanti, Konge, Lars, Clementsen, Paul Frost
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9777088/
https://www.ncbi.nlm.nih.gov/pubmed/36553134
http://dx.doi.org/10.3390/diagnostics12123127
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author Toennesen, Louise L.
Vindum, Helene H.
Risom, Ellen
Pulga, Alexis
Nessar, Rafi M.
Arshad, Arman
Christophersen, Alice
Park, Yoon Soo
Cold, Kristoffer Mazanti
Konge, Lars
Clementsen, Paul Frost
author_facet Toennesen, Louise L.
Vindum, Helene H.
Risom, Ellen
Pulga, Alexis
Nessar, Rafi M.
Arshad, Arman
Christophersen, Alice
Park, Yoon Soo
Cold, Kristoffer Mazanti
Konge, Lars
Clementsen, Paul Frost
author_sort Toennesen, Louise L.
collection PubMed
description Predicting factors of diagnostic yield in electromagnetic navigation bronchoscopy (ENB) have been explored in a number of previous studies based on data from experienced operators. However, little is known about predicting factors when the procedure is carried out by operators in the beginning of their learning curve. We here aim to identify the role of operators’ experience as well as lesion– and procedure characteristics on diagnostic yield of ENB procedures in the hands of novice ENB operators. Four operators from three centers without prior ENB experience were enrolled. The outcome of consecutive ENB procedures was assessed and classified as either diagnostic or non-diagnostic and predicting factors of diagnostic yield were assessed. A total of 215 procedures were assessed. A total of 122 (57%) of the ENB procedures resulted in diagnostic biopsies. Diagnostic ENB procedures were associated with a minor yet significant difference in tumor size compared to non-diagnostic/inconclusive ENB procedures (28 mm vs. 24 mm; p = 0.03). Diagnostic ENB procedures were associated with visible lesions at either fluoroscopy (p = 0.003) or radial endobronchial ultrasound (rEBUS), (p = 0.001). In the logistic regression model, lesion visibility on fluoroscopy, but none of operator experience, the presence of a bronchus sign, lesion size, or location nor visibility on rEBUS significantly impacted the diagnostic yield. In novice ENB operators, lesion visibility on fluoroscopy was the only factor found to increase the chance of obtaining a diagnostic sample.
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spelling pubmed-97770882022-12-23 When Pulmonologists Are Novice to Navigational Bronchoscopy, What Predicts Diagnostic Yield? Toennesen, Louise L. Vindum, Helene H. Risom, Ellen Pulga, Alexis Nessar, Rafi M. Arshad, Arman Christophersen, Alice Park, Yoon Soo Cold, Kristoffer Mazanti Konge, Lars Clementsen, Paul Frost Diagnostics (Basel) Article Predicting factors of diagnostic yield in electromagnetic navigation bronchoscopy (ENB) have been explored in a number of previous studies based on data from experienced operators. However, little is known about predicting factors when the procedure is carried out by operators in the beginning of their learning curve. We here aim to identify the role of operators’ experience as well as lesion– and procedure characteristics on diagnostic yield of ENB procedures in the hands of novice ENB operators. Four operators from three centers without prior ENB experience were enrolled. The outcome of consecutive ENB procedures was assessed and classified as either diagnostic or non-diagnostic and predicting factors of diagnostic yield were assessed. A total of 215 procedures were assessed. A total of 122 (57%) of the ENB procedures resulted in diagnostic biopsies. Diagnostic ENB procedures were associated with a minor yet significant difference in tumor size compared to non-diagnostic/inconclusive ENB procedures (28 mm vs. 24 mm; p = 0.03). Diagnostic ENB procedures were associated with visible lesions at either fluoroscopy (p = 0.003) or radial endobronchial ultrasound (rEBUS), (p = 0.001). In the logistic regression model, lesion visibility on fluoroscopy, but none of operator experience, the presence of a bronchus sign, lesion size, or location nor visibility on rEBUS significantly impacted the diagnostic yield. In novice ENB operators, lesion visibility on fluoroscopy was the only factor found to increase the chance of obtaining a diagnostic sample. MDPI 2022-12-12 /pmc/articles/PMC9777088/ /pubmed/36553134 http://dx.doi.org/10.3390/diagnostics12123127 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Toennesen, Louise L.
Vindum, Helene H.
Risom, Ellen
Pulga, Alexis
Nessar, Rafi M.
Arshad, Arman
Christophersen, Alice
Park, Yoon Soo
Cold, Kristoffer Mazanti
Konge, Lars
Clementsen, Paul Frost
When Pulmonologists Are Novice to Navigational Bronchoscopy, What Predicts Diagnostic Yield?
title When Pulmonologists Are Novice to Navigational Bronchoscopy, What Predicts Diagnostic Yield?
title_full When Pulmonologists Are Novice to Navigational Bronchoscopy, What Predicts Diagnostic Yield?
title_fullStr When Pulmonologists Are Novice to Navigational Bronchoscopy, What Predicts Diagnostic Yield?
title_full_unstemmed When Pulmonologists Are Novice to Navigational Bronchoscopy, What Predicts Diagnostic Yield?
title_short When Pulmonologists Are Novice to Navigational Bronchoscopy, What Predicts Diagnostic Yield?
title_sort when pulmonologists are novice to navigational bronchoscopy, what predicts diagnostic yield?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9777088/
https://www.ncbi.nlm.nih.gov/pubmed/36553134
http://dx.doi.org/10.3390/diagnostics12123127
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