PT  - JOURNAL ARTICLE
AU  - M.G. Slade
AU  - N.M. Rahman
AU  - A.E. Stanton
AU  - L. Curry
AU  - G.C. Slade
AU  - C.A. Clelland
AU  - F.V. Gleeson
TI  - Improving standards in flexible bronchoscopy for lung cancer
AID  - 10.1183/09031936.00097110
DP  - 2010 Jan 01
TA  - European Respiratory Journal
PG  - erj00971-2010
4099  - http://erj.ersjournals.com/content/early/2010/08/06/09031936.00097110.short
4100  - http://erj.ersjournals.com/content/early/2010/08/06/09031936.00097110.full
AB  - Can the detection rate of flexible bronchoscopy for lung cancer be increased by a series of simple quality improvement measures?Bronchoscopy-associated clinical parameters were prospectively recorded between from 2001–2007 in patients with suspected lung malignancy. The detection rate of bronchoscopy, diagnostic yield of each biopsy modality, and the possible impact of different service improvement measures were assessed.746 bronchoscopies were performed in 704 patients. The detection rate of bronchoscopy for malignancy was 83.6%, and increased over time (detection rate in 2001 67.3% (95% CI =52.9 to 79.7), detection rate in 2007 89.7% (% CI =81.3 to 95.2), p<0.001). Detection rate increased for both bronchoscopically visible (75.0% in 2001 to 94.5% in 2007) and non-visible tumour (41.7% in 2001 to 81.2% in 2007), p<0.001 for both analyses. Prior CT availability was associated with a higher diagnostic yield that did not reach statistical significance. Logistic regression analysis identified tumour visibility, year of study, use of transbronchial needle aspiration and pathologist identity as independent predictors of a positive diagnosis.A significant increase in bronchoscopic detection rate for malignancy occurred in association with a number of simple improvement measures.