RT Journal Article
SR Electronic
T1 Improving standards in flexible bronchoscopy for lung cancer
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00971-2010
DO 10.1183/09031936.00097110
A1 M.G. Slade
A1 N.M. Rahman
A1 A.E. Stanton
A1 L. Curry
A1 G.C. Slade
A1 C.A. Clelland
A1 F.V. Gleeson
YR 2010
UL http://erj.ersjournals.com/content/early/2010/08/06/09031936.00097110.abstract
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.