Diagnostic accuracy outcomes of office‐based (outpatient) biopsies in patients with laryngopharyngeal lesions: A systematic review

Abstract

Background:In-office biopsies (IOB) using local anaesthetic for laryngopharyngeal tumours has become an increasingly popular approach since the advent of distal chip endoscopes. Although a wide range of studies advocate use in clinical practice, the widespread application of the procedure is hampered by concerns regarding diagnostic accuracy.Objective: To assess the diagnostic accuracy of IOB performed via flexible endoscopy.In addition, to analyse modifiable factors that may affect diagnostic accuracy of IOB.Design: A systematic review following the PRISMA guidelines was conducted.PubMed, EMBASE, the Cochrane Library, Web of Science and CINAHL were used in the literature database search. Quality assessment of included studies was perfomed using the Newcastle-Ottawa Scale.Results: A total of 875 studies were identified, 16 of which were included into the systematic review; 1572 successful biopsies were performed using flexible endoscopy; 1283 cases were accurately diagnosed in the outpatient setting (81.6%) and 289 samples did not provide an accurate diagnosis (18.4%). The median sensitivity of IOB was 73%, and the specificity was 96.7%. Analysis of variable factors did not show any significant differences in method of approach, size of equipment (forceps) and additional lighting system or learning curve. Conclusion:IOB are a viable tool for diagnostic workup of laryngopharyngeal tumours. Clinicians should be wary of reported limitations of IOB when benign or pre-malignant diagnoses are made. In cases suspicious of malignancy, confirmatory investigation should be conducted.

Prospective cohort study assessing patient satisfaction and diagnostic accuracy in channeled endoscope local anesthetic biopsy in the investigation of head and neck cancer

“…This is comparable to other studies investigating the diagnostic accuracy of LA biopsy, with reported sensitivity ranging from 60% to 97% 5,8–14 . A recent systematic review on the diagnostic accuracy of LA biopsy, Owusu‐Ayim et al, published a median sensitivity for in‐office biopsy of 73% 15 . With our diagnostic accuracy being comparable to that of other studies, it suggests that we are meeting a satisfactory level of procedural quality in terms of tissue acquisition to make our results relevant and applicable more broadly, thus ensuring a degree of external validity.…”

The sensitivity of laryngeal findings in predicting high‐grade dysplasia in patients with vocal fold leukoplakia undergoing office‐based biopsies: A retrospective analysis of 100 cases

“…In the outpatient setting, 81.6% of cases were accurately diagnosed with a median sensitivity and specificity of 73% and 96.7%, respectively, for in-office biopsies. 18 The results of this investigation reinstate the sensitivity of the laryngeal findings in predicting high-grade dysplasia/CIS and SCC in vocal fold leukoplakia biopsied in the office. Nevertheless, this study has its limitations.…”

“…Sixteen studies were included in the review with a total of 1572 biopsies that were performed using flexible endoscopy. In the outpatient setting, 81.6% of cases were accurately diagnosed with a median sensitivity and specificity of 73% and 96.7%, respectively, for in‐office biopsies 18 …”

“…In the outpatient setting, 81.6% of cases were accurately diagnosed with a median sensitivity and specificity of 73% and 96.7%, respectively, for in‐office biopsies. 18 …”

A Review of the Digitalization of Agriculture in Nigeria

“…All the stages were done manually apart from the removal of duplicates which was done using the 2018 Clarivate Endnote X9. Having considered our inclusion and exclusion criteria, articles that scaled through were evaluated using a clear-cut guide assessment (Table 1) as used by Ayim et al, 2022.…”