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Special Report: ArticlesUnderutilization of Transbronchial Needle Aspiration: Experiences of Current Pulmonary Fellows
Section snippets
Materials and Methods
We recorded the computerized responses of pulmonary Fellows attending a presentation about TBNA at an interactive Fellows' Conference sponsored by the American College of Chest Physicians in October 1995, and noted the frequencies of their answers to the following multiple choice questions:
- 1.
How often do you perform TBNA in diagnosing or staging malignant disease?
- 1.
Routinely (≫85% of cases)
- 2.
Often (50-84% of cases)
- 3.
Sometimes (6-49% of cases)
- 4.
Rarely (≫5% of cases)
- 2.
In patients with
Results
Interactive responses were recorded from 109 Fellows. Their estimates of the frequencies with which they performed TBNA in patients with malignant disease are summarized in Figures 1 and 2. Only 10% reported that they routinely performed TBNA to diagnose or stage malignant disease, and 40% noted that they rarely performed it. Their estimates of diagnostic yields (Fig 2) varied considerably, but approximately half reported yield ≥25%.
Fellows' perspectives of the main limitations of TBNA are
Discussion
Despite numerous limitations related to selection bias, possible inaccurate recollections of their own TBNA experience, and other factors, we believe that the overall views of Fellows about their TBNA experiences provide worthwhile information that should prompt concerns about the breadth of the bronchoscopy training that they receive. TBNA is currently underutilized and/or underemphasized at bronchoscopy training programs. The similarity of these Fellows' estimates of the frequency of TBNA
ACKNOWLEDGMENTS
The writers thanks Renata Simonsen and the ACCP for the superb coordination of the conference and for facilitating data collection, and Maxine Davis for secretarial assistance.
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Interventional Bronchoscopy
2021, Encyclopedia of Respiratory Medicine, Second EditionThe competence debate: Response
2014, ChestEndobronchial ultrasound-guided transbronchial needle aspiration in diagnosing intrathoracic tuberculosis
2013, Annals of Thoracic SurgeryCitation Excerpt :The diagnostic yield of EUS-FNA for TB is up to 90% but, when the target is the right paratracheal and hilar nodes, sites frequently involved by TB, this area cannot be punctured [14]. Conventional TBNA of mediastinal nodes is useful for diagnosing TBLA, but this relatively blind procedure has limited use [15, 16]. The utility of EBUS-TBNA in the diagnosis of intrathoracic TB in our study was satisfactory.
revision accepted December 5.