Evidence map›Paper›PMID 25922723›Full record

ArticleJournal of thoracic disease2015

Utility of EBUS-TBNA for diagnosis of mediastinal tuberculous lymphadenitis: a multicentre Australian experience.

James Geake, Gary Hammerschlag, Phan Nguyen, Peter Wallbridge, Grant A Jenkin, Tony M Korman, Barton Jennings, Douglas F Johnson, Louis B Irving, Michael Farmer and 1 more

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thoracic disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02690610 (Value of Rapid on Site Evaluation During Endobronchial Ultrasound Guided Trans-bronchial Needle Aspiration), which is not on this map. Cited by 29 papers.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed
5.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02690610 nacompletednot on this map

Value of Rapid on Site Evaluation During Endobronchial Ultrasound Guided Trans-bronchial Needle Aspiration (EBUS-TBNA) in the Diagnosis of Mediastinal Lesions

TypeinterventionalSponsorTanta UniversityRan2015 to 2016Enrolled67ConditionsMediastinumArmsEBUS TBNA of mediastinal lesions or lymph nodes
3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 59 citations in OpenAlex.

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  14. Recent developments in advanced diagnostic bronchoscopy.European respiratory review : an official journal of the European Respiratory Society · 2020
    Review
  15. Limbic encephalitis associated with tuberculous mediastinal lymphadenitis.Journal of clinical tuberculosis and other mycobacterial diseases · 2020
    Article
  16. Observational
  17. Endobronchial fungal infection caused byOxford medical case reports · 2019
    Article
  18. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

James Geake1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
Gary Hammerschlag1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
Phan Nguyen1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
Peter Wallbridge1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
Grant A Jenkin1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
Tony M Korman1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
Barton Jennings1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
Douglas F Johnson1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
Louis B Irving1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
Michael Farmer1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
Daniel P Steinfort1 Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Brisbane 4032, Australia ; 2 Department Respiratory Medicine, The Royal Melbourne Hospital, Parkville 3050, Australia ; 3 Department of Thoracic Medicine, The Royal Adelaide Hospital, Adelaide 5000, Australia ; 4 Department of Infectious Diseases, Austin Hospital, Heidelberg 3084, Australia ; 5 Department of Infectious Diseases, 6 Monash Lung and Sleep, Monash Medical Centre, Clayton 3168, Australia ; 7 Department of Medicine, University of Melbourne, Parkville 3010, Australia.
The Royal Melbourne Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndobronchial ultrasound (EBUS) transbronchial needle aspiration (TBNA) is an important diagnostic procedure for the interrogation of mediastinal lymph nodes. There is limited data describing the accuracy & safety of this technique for the diagnosis of tuberculous mediastinal lymphadenitis.

methodsA multi-centre retrospective study of all EBUS-guided TBNA procedures that referred samples for mycobacteriology was performed. Results were correlated with post-procedural diagnoses after a period of surveillance and cross-checked against relevant statewide tuberculosis (TB) registries, and sensitivity and specificity was calculated. In addition, nucleic acid amplification techniques (NAAT) were assessed, and sensitivity and specificity calculated using positive mycobacterial culture as the reference gold standard.

resultsOne hundred and fifty-nine patients underwent EBUS-TBNA and had tissue referred for mycobacterial culture, of which 158 were included in the final analysis. Thirty-nine were ultimately diagnosed with TB (25%). Sensitivity of EBUS-TBNA for microbiologically confirmed tuberculous mediastinal lymphadenitis was 62% (24/39 cases). Specificity was 100%. Negative predictive value (NPV) and diagnostic accuracy for microbiologic diagnosis was 89% [95% confidence intervals (CI), 82-93%] and 91% (95% CI, 84-94%) respectively. For a composite clinicopathologic diagnosis of TB NPV and accuracy were 98% (95% CI, 93-99%) and 98% (95% CI, 95-99%) respectively. Sensitivity for NAAT was 38% (95% CI, 18-65%).

conclusionsEBUS-TBNA is a safe and well tolerated procedure in the assessment of patients with suspected isolated mediastinal lymphadenitis and demonstrates good sensitivity for a microbiologic diagnosis of isolated mediastinal lymphadenitis. When culture and histological results are combined with high clinical suspicion, EBUS-TBNA demonstrates excellent diagnostic accuracy and NPV for the diagnosis of mediastinal TB lymphadenitis. We suggest EBUS-TBNA should be considered the procedure of choice for patients in whom TB is suspected.

Indexed as

bronchoscopycultureEndobronchial ultrasound (EBUS)minimally invasivemycobacteriaPCRtuberculosis (TB)

Identifiers

PMID25922723
PMCPMC4387413
OpenAlexW1951311474

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.