Evidence map›Paper›PMID 31464652›Full record

ArticleJournal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale2019

Utility of clinical features with fine needle aspiration biopsy for diagnosis of Warthin tumor.

Thomas So, Axel Sahovaler, Anthony Nichols, Kevin Fung, John Yoo, Michele M Weir, S Danielle MacNeil

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
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

7 authors at 1 institution in 1 country.

Thomas SoSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Axel SahovalerDepartment of Otolaryngology-Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada.
Anthony NicholsDepartment of Otolaryngology-Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada.
Kevin FungDepartment of Otolaryngology-Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada.
John YooDepartment of Otolaryngology-Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada.
Michele M WeirDepartment of Pathology and Laboratory Medicine, Western University and London Health Sciences Centre, London, ON, Canada.
S Danielle MacNeilDepartment of Otolaryngology-Head and Neck Surgery, Western University and London Health Sciences Centre, London, ON, Canada. Danielle.Macneil@lhsc.on.ca.ORCID http://orcid.org/0000-0001-6666-9055
Western University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConservative management of Warthin tumor (WT) may be a viable alternative to surgery, but there are concerns of missed malignancies on fine needle aspiration biopsy (FNAB). The purpose of this study is to measure the sensitivity and positive predictive value of FNAB for WT, and to identify clinical features associated with WT that can aid in this diagnosis.

methodsRetrospective analysis of patients from January 1, 2006 to April 30, 2017 at a tertiary care center in London, Ontario, Canada. All patients with a diagnosis of WT on FNAB or resection were included. Electronic medical records were identified for 177 patients that fit the criteria. Study outcomes included the sensitivity and positive predictive value of FNAB alone for WT, and, when including clinical features associated with WT.

resultsThe mean age of patients in this study was 63.2 years (SD 10.4); 115 (65%) were male, and 157 (89%) were past or present smokers. The measured sensitivity and positive predictive value of FNAB for WT were 95.8 and 97.2% respectively. Two cases were classified as WT on FNAB but confirmed at resection as mucoepidermoid carcinoma and acinic cell carcinoma. When only patients with multifocal, bilateral or incidental tumors were assessed, sensitivities and positive predictive values for each were 100%. Isolating for inferior pole location also resulted in a positive predictive value of 100%.

conclusionsThe sensitivity and positive predictive value of FNAB for WT in this study are high, with two false negatives on FNAB. Multifocal, bilateral, incidentaloma and inferior pole location were identified as potential clinical features that may increase the diagnostic confidence for WT, strengthening the argument for conservative management in these patients. Overall, this study serves as an initial exploration into whether clinical features may be included with FNAB results to improve the sensitivity and positive predictive value of diagnosing WT. Further research is necessary before these findings can be translated into clinical practice.

Indexed as

Biopsy, Fine-NeedleAdenolymphomaFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesSensitivity and SpecificityClinical featuresFine needle aspiration biopsyPositive predictive valueResectionSensitivityWarthin tumor

Identifiers

PMID31464652
PMCPMC6716907
OpenAlexW2971132047

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.