Improving standards in flexible bronchoscopy for lung cancer

Abstract

Can the detection rate of flexible bronchoscopy for lung cancer be increased by a series of simple quality improvement measures?Bronchoscopy . Prior computed tomography 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.

British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE

“…Based on recent evidence, it is reasonable to expect a diagnostic yield of 85% when the tumour is visible at bronchoscopy using bronchial biopsy 149 150. Slade et al 149 examined the diagnostic yield from FB at a single centre between 2001 and 2007.…”

“…Slade et al 149 examined the diagnostic yield from FB at a single centre between 2001 and 2007. In patients with tumour visible at bronchoscopy, the yield increased from 75% in 2001 to 94.5% in 2007.…”

Integrated Care Pathways in Lung Cancer: A Quality Improvement Project

“…The remaining eight indicators values were statistically different from benchmark, as you can see below. The percentage of diagnostic bronchoscopic procedures was 60.7 percent (observed) versus 80-85 percent (benchmark) (see also Table 4) (32)(33)(34). No extemporary cytology was performed during bronchoscopy, dramatically far below the 100 percent benchmark value (34).…”

Exposure to Mycobacterium tuberculosis during Flexible Bronchoscopy in Patients with Unexpected Pulmonary Tuberculosis

“…Flexible bronchoscopy is a valuable diagnostic method for various neoplastic and non-neoplastic lung diseases [ 1 , 2 ]. In patients with suspected pulmonary tuberculosis (PTB) in whom the sputum smear is negative for acid-fast staining, bronchoscopy with bronchial washing or bronchoalveolar lavage (BAL) is particularly useful to verify the diagnosis [ 3 , 4 ].…”