Evidence map›Paper›PMID 31593653›Full record

ArticleThe Annals of thoracic surgery2020

Improved Diagnostic Yield and Specimen Quality With Endobronchial Ultrasound-Guided Forceps Biopsies: A Retrospective Analysis.

Amrik S Ray, Changyi Li, Terrence E Murphy, Guoping Cai, Katy L B Araujo, Kyle Bramley, Erin M DeBiasi, Margaret A Pisani, Isabel Oliva Cortopassi, Jonathan T Puchalski

Open access · bronzeAbstract readVideo-Audio Media
In one paragraph

Article in The Annals of thoracic surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
2.1field-weighted citation impact, top 12% 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

19 citing papers in PubMed, 41 citations in OpenAlex.

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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

10 authors at 2 institutions in 2 countries.

Amrik S RayDivision of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut.
Changyi LiDivision of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut; Department of Pulmonary Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Terrence E MurphyClaude D. Pepper Older Americans Independence Center at Yale, Program on Aging, Yale School of Medicine, New Haven, Connecticut.
Guoping CaiDepartment of Pathology, Yale University School of Medicine, New Haven, Connecticut.
Katy L B AraujoClaude D. Pepper Older Americans Independence Center at Yale, Program on Aging, Yale School of Medicine, New Haven, Connecticut.
Kyle BramleyDivision of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut.
Erin M DeBiasiDivision of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut.
Margaret A PisaniDivision of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut.
Isabel Oliva CortopassiDepartment of Radiology, Yale University School of Medicine, New Haven, Connecticut.
Jonathan T PuchalskiDivision of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut. Electronic address: jonathan.puchalski@yale.edu.
Yale University · USSecond Affiliated Hospital of Chongqing Medical University · CN

Funding

Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Denise Esserman · 2002 to 2026
$37.9M
NIA NIH HHS P30 AG021342
6 · The paper itself

Abstract

backgroundEndobronchial ultrasound (EBUS) transbronchial needle aspiration (TBNA) has a high diagnostic yield when evaluating mediastinal and hilar lymphadenopathy (LAD). Having previously demonstrated the safety of EBUS-guided cautery-assisted transbronchial nodal forceps biopsy (ca-TBFB), we report disease-specific improvements in diagnostic yield and tissue acquisition when supplementing the EBUS-TBNA-based standard of care (SOC) with ca-TBFB.

methodsWe retrospectively reviewed 213 patients who sequentially underwent SOC and ca-TBFB during the same procedure. We determined 3 clinical scenarios of interest based on preprocedural imaging: isolated mediastinal/hilar LAD, LAD associated with a nodule or mass suspicious for malignancy, and LAD associated with parenchymal findings suggestive of sarcoidosis. Using validated methods, we assessed diagnostic yield on a per-patient basis and specimen quality on a per-node basis on the 136 patients meeting diagnostic criteria.

resultsAdministration of disease-specific SOC with ca-TBFB yielded gains that varied by diagnosis. Diagnostic yields of SOC and its supplementation with ca-TBFB were 91.8% and 93.4% (P = .50) of the 61 patients diagnosed with solid-organ malignancy, 62.7% and 94.9% (P < .001) of the 59 patients diagnosed with sarcoidosis, and 62.5% and 93.8% (P = .042) of the 16 patients diagnosed with lymphoma, the. For each disease process, specimens obtained with ca-TBFB exhibited statistically higher quality.

conclusionsWe suggest that relative to SOC, ca-TBFB improves diagnostic yield for sarcoidosis and lymphoma while providing uniformly better tissue quality and cellularity. We propose a protocol for use of this innovative technique.

Indexed as

Surgical InstrumentsAgedBronchoscopyDiagnosis, DifferentialEndoscopic Ultrasound-Guided Fine Needle AspirationFemaleHumansLymphadenopathyLymph NodesMaleMediastinal DiseasesMiddle AgedReproducibility of ResultsRetrospective Studies

Identifiers

PMID31593653
PMCPMC9376016
OpenAlexW2977789511

What OpenQuestion holds

Textmetadata
LicenceTDM
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.