Evidence map›Paper›PMID 34301713›Full record

ArticleBMJ open respiratory research2021

Low utilisation of bronchoscopy to assess COVID-19 respiratory infection: a multicenter experience.

Kamran Mahmood, Matt Abbott, Keriann Van Nostrand, Rabih Bechara, Anne V Gonzalez, Amanda Brucker, Cynthia L Green, Christopher R Polage

Open access · goldAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.7field-weighted citation impact, top 16% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
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

8 authors at 4 institutions in 2 countries.

Kamran MahmoodDepartment of Medicine, Division of Pulmonary, Allergy and Critical Care, Duke University, Durham, North Carolina, USA k.mahmood@duke.edu.
Matt AbbottDepartment of Medicine, Division of Pulmonary, Allergy and Critical Care, Duke University, Durham, North Carolina, USA.
Keriann Van NostrandDepartment of Medicine, Division of Pulmonary and Critical Care, Emory University, Atlanta, Georgia, USA.
Rabih BecharaDepartment of Medicine, Division of Pulmonary and Critical Care, Medical College of Georgia, Augusta, Georgia, USA.
Anne V GonzalezDepartment of Medicine, Division of Pulmonary and Critical Care, McGill University, Montreal, Quebec, Canada.
Amanda BruckerDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA.
Cynthia L GreenDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA.
Christopher R PolageDepartment of Pathology, Duke University, Durham, North Carolina, USA.
Duke University · USAugusta University · USEmory University · USMcGill University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveFor the diagnosis of COVID-19, the yield of nasopharyngeal (NP) swabs is unclear, and bronchoalveolar lavage (BAL) is obtained to confirm the diagnosis. We assessed the utilisation of bronchoscopy for COVID-19 diagnosis in a multicenter study and compared the diagnostic yield of BAL versus NP swabs.

methodsThis retrospective study included all patients who were admitted with clinical presentation concerning for COVID-19 and underwent BAL from 1 March to 31 July 2020 at four tertiary care centres in North America. We also compared concordance of BAL with NP swabs for diagnosis of COVID-19 infection.

resultsFifty-three patients, with clinical suspicion for COVID-19 and admitted for respiratory failure, underwent bronchoscopy to collect BAL for SARS-CoV-2 testing. During the same period, 2039 bronchoscopies were performed on patients not infected with COVID-19. Of 42 patients with NP swabs and BAL collected within ≤7 days, 1 was NP swab negative but positive by BAL for SARS-CoV-2 (n=1/42 (2.4%)). Across a wide array of testing platforms, the overall agreement between NP swabs and BAL results was 97.6% (95% CI: 93.0% to 100%) with Cohen's k of 0.90 (95% CI: 0.69 to 1.00). The sensitivity, specificity, positive and negative predictive values of NP swabs compared with BAL were 83.3% (95% CI: 53.5% to 100%), 100%, 100% and 97.3% (95% CI: 92.1% to 100%), respectively.

conclusionsBAL was used infrequently to assess COVID-19 in busy institutions. NP swabs have a high concordance with BAL for COVID-19 testing, but negative NP swabs should be confirmed with BAL when clinical suspicion is high.

Indexed as

AgedBronchoalveolar Lavage FluidBronchoscopyCOVID-19COVID-19 TestingFemaleHumansMaleMiddle AgedNasopharynxNorth AmericaPredictive Value of TestsRetrospective StudiesSARS-CoV-2bronchoscopyCOVID-19respiratory infection

Identifiers

PMID34301713
PMCPMC8313310
OpenAlexW3183294618

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.