International Journal of Hematology and Oncology
2023, Vol 33, Num 4 Page(s): 059-065
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The Effect of the Operator Learning Curve on Diagnostic Accuracy for Lung Cancer with Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Single-Center Observational Study
Rusen UZUN1, Fatih UZER2
1Antalya Training and Research Hospital, Department of Respiratory Diseases, Antalya, TURKEY
2Kastamonu State Hospital, Department of Respiratory Diseases, Kastamonu, TURKEY
Keywords: EBUS, Learning curve, Lung cancer, Diagnostic accuracy
We aimed to investigated the relationship between diagnostic accuracy of ultrasound-guided trans-bronchial needle aspiration (EBUSTBNA) and the number of procedure performed by operator. We included all consecutively attended patients undergoing EBUS-TBNA for diagnosis of lung cancer. The pathology prearations were evaluated by the same single pathologist. Rapid on-site examination (ROSE) was performed for all patients. To determine the impact of operator experience on the accuracy of EBUS-TBNA-based diagnosis, patients were divided into three equally sized groups based on the chronological order of their EBUS-TBNA assessment. A total of 270 patients were included in the study. The most common indication for undergoing the EBUS-TBNA procedure was tumor staging (44.1%). ROC analysis revealed that the study bronchoscopist’s diagnosis of malignancy based on EBUS-TBNA images were consistent with the final pathologist’s diagnosis in 73% of the first 90 cases (p= 0.02), 90% of the second 90 cases (p= 0.01), and 98% of the third 90 cases (p= 0.01). In the first 90 cases, the sensitivity of the bronchoscopist’s diagnosis was 74%, the specificity was 78%, the positive predictive value was 76%, and the negative predictive value was 85%. In the second 90 cases, the sensitivity was 94%, the specificity was 92%, the positive predictive value was 95%, and the negative predictive value was 95%. In the third 90 cases, the sensitivity was 98%, the specificity was 98%, the positive predictive value was 98%, and the negative predictive value was 100%. We observed that as the number of EBUS-TBNA procedures that the operator performed increased, his diagnostic accuracy approached perfection.
Rusen UZUN1, Fatih UZER2
1Antalya Training and Research Hospital, Department of Respiratory Diseases, Antalya, TURKEY
2Kastamonu State Hospital, Department of Respiratory Diseases, Kastamonu, TURKEY
Keywords: EBUS, Learning curve, Lung cancer, Diagnostic accuracy
We aimed to investigated the relationship between diagnostic accuracy of ultrasound-guided trans-bronchial needle aspiration (EBUSTBNA) and the number of procedure performed by operator. We included all consecutively attended patients undergoing EBUS-TBNA for diagnosis of lung cancer. The pathology prearations were evaluated by the same single pathologist. Rapid on-site examination (ROSE) was performed for all patients. To determine the impact of operator experience on the accuracy of EBUS-TBNA-based diagnosis, patients were divided into three equally sized groups based on the chronological order of their EBUS-TBNA assessment. A total of 270 patients were included in the study. The most common indication for undergoing the EBUS-TBNA procedure was tumor staging (44.1%). ROC analysis revealed that the study bronchoscopist’s diagnosis of malignancy based on EBUS-TBNA images were consistent with the final pathologist’s diagnosis in 73% of the first 90 cases (p= 0.02), 90% of the second 90 cases (p= 0.01), and 98% of the third 90 cases (p= 0.01). In the first 90 cases, the sensitivity of the bronchoscopist’s diagnosis was 74%, the specificity was 78%, the positive predictive value was 76%, and the negative predictive value was 85%. In the second 90 cases, the sensitivity was 94%, the specificity was 92%, the positive predictive value was 95%, and the negative predictive value was 95%. In the third 90 cases, the sensitivity was 98%, the specificity was 98%, the positive predictive value was 98%, and the negative predictive value was 100%. We observed that as the number of EBUS-TBNA procedures that the operator performed increased, his diagnostic accuracy approached perfection.
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