Respiratory medicine最新文献

{"title":"Azithromycin's role in COVID-19 outcomes: Antibacterial or antiviral action?","authors":"Chia Siang Kow, Dinesh Sangarran Ramachandram, Syed Shahzad Hasan, Kaeshaelya Thiruchelvam","doi":"10.1016/j.rmed.2024.107902","DOIUrl":"10.1016/j.rmed.2024.107902","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"236 ","pages":"Article 107902"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab reduces exacerbations and improves lung function in patients with chronic obstructive pulmonary disease and emphysema: Phase 3 randomized trial (BOREAS)","authors":"Surya P. Bhatt ,&nbsp;Klaus F. Rabe ,&nbsp;Nicola A. Hanania ,&nbsp;Claus F. Vogelmeier ,&nbsp;Mona Bafadhel ,&nbsp;Stephanie A. Christenson ,&nbsp;Alberto Papi ,&nbsp;Dave Singh ,&nbsp;Elizabeth Laws ,&nbsp;Paula Dakin ,&nbsp;Jennifer Maloney ,&nbsp;Xin Lu ,&nbsp;Deborah Bauer ,&nbsp;Ashish Bansal ,&nbsp;Lacey B. Robinson ,&nbsp;Raolat M. Abdulai","doi":"10.1016/j.rmed.2024.107846","DOIUrl":"10.1016/j.rmed.2024.107846","url":null,"abstract":"<div><h3>Background</h3><div>Dupilumab, a fully human monoclonal antibody that blocks the shared receptor component for interleukin-4 and interleukin-13, reduced exacerbations and improved lung function in patients with chronic obstructive pulmonary disease (COPD) and type 2 inflammation in the phase 3 BOREAS trial.</div></div><div><h3>Objective</h3><div>To assess clinical outcomes in patients from BOREAS by emphysema status.</div></div><div><h3>Methods</h3><div>Patients with COPD and type 2 inflammation (screening blood eosinophils ≥300 cells/μL) on maximal inhaled therapy were randomized to add-on dupilumab 300 mg or placebo every 2 weeks for 52 weeks. We assessed the annualized moderate/severe COPD exacerbation rates over 52 weeks and change from baseline to Week 12 in prebronchodilator forced expiratory volume in 1 s (FEV₁) in patients with and without investigator-reported emphysema.</div></div><div><h3>Results</h3><div>Investigator-reported emphysema was present in 306/939 patients (32.6 %) at baseline. Dupilumab reduced exacerbation rates vs placebo by 29 % (relative risk [RR] 0.71 [95 % CI 0.53–0.95]) and 31 % (RR 0.69 [95 % CI 0.53–0.89]) in patients with and without emphysema, respectively. Prebronchodilator FEV₁ least squares mean difference from baseline to Week 12 for dupilumab vs placebo was 0.07 L ([95 % CI 0.002–0.14]) and 0.09 L ([95 % CI 0.04–0.14]) in patients with and without emphysema, respectively. No treatment by emphysema interaction effect was observed for the annualized rate of exacerbations (<em>P</em> value for interaction = 0.8296) or change in prebronchodilator FEV₁ (<em>P</em> value for interaction = 0.6438).</div></div><div><h3>Conclusion</h3><div>Dupilumab efficacy was similar in patients with COPD and type 2 inflammation, with or without investigator-reported emphysema.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"236 ","pages":"Article 107846"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End-tidal carbon dioxide, a point-of-care biomarker to assess severity in acute asthma: A systematic review","authors":"Sanjay Farshid ,&nbsp;Benjamin C. Buckland ,&nbsp;Selvanaayagam Shanmuganathan ,&nbsp;Gary KK. Low","doi":"10.1016/j.rmed.2024.107891","DOIUrl":"10.1016/j.rmed.2024.107891","url":null,"abstract":"<div><h3>Background and objective</h3><div>Accurate severity assessment in acute asthma is vital to guide patient management and disposition. End-tidal carbon dioxide (EtCO₂) has been proposed as a real-time measure for this purpose. This study aimed to systematically review literature on EtCO₂ measurement in assessing the severity of acute asthma exacerbations.</div></div><div><h3>Methods</h3><div>Five databases were searched. Studies with patients of any age with acute asthma exacerbations and at least one clinical outcome measure were included. Studies on intubated patients and outpatients were excluded. Two independent reviewers screened abstracts and then full texts for eligibility.</div></div><div><h3>Results</h3><div>1242 records were identified and 11 studies were included in the review. Three out of five studies found significant differences in capnography measures between patients eventually admitted and those discharged from the emergency department. Patients with lower initial EtCO₂ were more likely to require hospital admission. Other components of the capnography waveform were associated with disposition, including a larger alpha angle and a lower ratio between phase III duration and respiratory rate being associated with hospital admission. Seven studies examined correlations between capnography measures and other markers of airway obstruction and weak or absent correlations were generally found. Three studies reported significant change in capnography measures after treatment.</div></div><div><h3>Conclusion</h3><div>Lower EtCO₂ may predict poorer outcome in acute asthma exacerbations. Other measures taken from the capnography waveform appear to be useful indicators of severity. Addressing patient selection issues and conducting prognostic accuracy studies of EtCO₂ with clinical endpoints may provide meaningful evidence for clinical practice.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"236 ","pages":"Article 107891"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maximal inspiratory pressure and exercise-induced inspiratory muscle fatigue in chronic nonspecific low back pain","authors":"Sim Klaps ,&nbsp;Jonas Verbrugghe ,&nbsp;Nina Goossens ,&nbsp;Timo Meus ,&nbsp;Albère Köke ,&nbsp;Jeanine Verbunt ,&nbsp;Daniel Langer ,&nbsp;Annick Timmermans ,&nbsp;Lotte Janssens","doi":"10.1016/j.rmed.2024.107887","DOIUrl":"10.1016/j.rmed.2024.107887","url":null,"abstract":"<div><h3>Background</h3><div>Patients with chronic nonspecific low back pain (CNSLBP) show reduced inspiratory muscle function. However, studies comparing maximal inspiratory pressure (MIP) and exercise-induced inspiratory muscle fatigue (IMF) between CNSLBP and healthy controls (HC) are lacking. Objective: To compare MIP and exercise-induced IMF between CNSLBP and HC. Design: Cross-sectional study. Methods: MIP was recorded in 25 persons with CNSLBP and 15 HC before and immediately, 15 and 30 minutes after a maximal cardiopulmonary exercise test. Inspiratory muscle weakness was defined as a predicted MIP value lower than 80%, and exercise-induced IMF as a ≥10% reduction in MIP following the exercise test.</div></div><div><h3>Results</h3><div>Baseline MIP was similar between CNSLBP (109±32 cmH2O) and HC (116±32 cmH2O) (p= 0.525). Inspiratory muscle weakness was present in 36% of the CNSLBP group and in 20% of the HC group, with no significant difference between groups (p= 0.777). None of the groups showed significant exercise-induced IMF immediately (CNSLBP: -2.1%, HC: 3.7%), 15 minutes (CNSLBP: -5.4%, HC: -5.2%), and 30 minutes (CNSLBP: -4.7%, HC: -6.6%) after the maximal exercise test (p&gt; 0.05), with no between group differences with regard to magnitude and proportion (CNSLBP: 24%, HC: 33%) (p&gt; 0.05).</div></div><div><h3>Conclusions</h3><div>This study shows that there is no difference in MIP and the proportion of inspiratory muscle weakness between persons with CNSLBP and HC. Additionally, within both groups, there was no exercise-induced IMF immediately, 15 and 30 minutes after a maximal exercise test. Furthermore, there was no difference in the magnitude and proportion of exercise-induced IMF between both groups.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"236 ","pages":"Article 107887"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Particularities of deposition of two ICS-LABA fixed dose combination dry powder aerosol drugs in the airways of COPD patients","authors":"Alpár Horváth ,&nbsp;Árpád Farkas ,&nbsp;Izolda Réti ,&nbsp;Norbert Ilyés ,&nbsp;Botond Havadtői ,&nbsp;Tamás Kovács ,&nbsp;Balázs Sánta ,&nbsp;Erika Kis ,&nbsp;Zoltán Bártfai ,&nbsp;Renáta Marietta Böcskei ,&nbsp;Gabriella Gálffy","doi":"10.1016/j.rmed.2024.107916","DOIUrl":"10.1016/j.rmed.2024.107916","url":null,"abstract":"<div><div>The aim of this study was to analyse the effect of breathing parameters, age, gender and disease status on the lung doses of the two ICS + LABA fixed combination dry powder drugs. Breathing parameters of 113 COPD patients were measured while inhaling through emptied NEXThaler® and Ellipta® inhalers and the corresponding lung doses were calculated. Lung dose of Foster® NEXThaler® was superior to the lung dose of Relvar® Ellipta® in around 85 % of the patients. The average value of the ratio of bronchiolar to bronchial deposition fractions was 5.0 for Foster® NEXThaler® and 2.6 for Relvar® Ellipta®. Lung dose was sensitive to the inhalation parameters, such as peak inhalation flow, inhaled volume and breath-hold time. For both studied drugs the dose to the lungs was relatively high for moderate PIF values, but it declined for low (&lt;35 L/min) and high (&gt;95 L/min) PIFs. The lung dose increased by the increase of the inhaled volume, but saturated over 1.0 L of inhaled air. Longer breath-hold time led to higher lung deposition, but the dependence was drug-specific. FEV₁ (%) and FEV₁/FVC (%) did not influence the lung dose significantly (p = 0.05). Exacerbating patients had lower lung doses (28.8 ± 5.8 % for Foster® NEXThaler® and 23.7 ± 3.8 % for Relvar® Ellipta®) than their non-exacerbating counterparts (33.7 ± 6.1 % for Foster® NEXThaler® and for 24.9 ± 3.9 % for Relvar® Ellipta®). The exact clinical consequences of the differences between the deposition distributions of the two drugs could be assessed only by systematic clinical trials.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"236 ","pages":"Article 107916"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversibility of airwave oscillometry in COPD","authors":"Robert Greig,&nbsp;Chris RuiWen Kuo,&nbsp;Rory Chan,&nbsp;Brian Lipworth","doi":"10.1016/j.rmed.2024.107915","DOIUrl":"10.1016/j.rmed.2024.107915","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"236 ","pages":"Article 107915"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of physiotherapy modalities on persisting dyspnoea in long COVID: A systematic review and meta-analysis","authors":"Christophe Romanet ,&nbsp;Johan Wormser ,&nbsp;Marine Cachanado ,&nbsp;María Granados Santiago ,&nbsp;Gilles Chatellier ,&nbsp;Marie Carmen Valenza ,&nbsp;François Philippart","doi":"10.1016/j.rmed.2024.107909","DOIUrl":"10.1016/j.rmed.2024.107909","url":null,"abstract":"<div><h3>Background</h3><div>Dyspnoea is often found months and years later in the “long-covid” syndrome, impairing quality of life and further perpetuating anxiety and post-traumatic stress disorders. Physiotherapy was recommended as a treatment in long-covid, but there is still insufficient evidence on its effectiveness.</div></div><div><h3>Methods</h3><div>We conducted a systematic literature search on MEDLINE, PEDro, WOS, Scopus, VHL and the Cochrane Library until July 2023 (PROSPERO registration number: CRD42023427464). We selected comparative trials including adults with persistent breathlessness following COVID-19, regardless of the initial severity, for whom physiotherapy was implemented as a treatment for dyspnoea. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and assessed the study quality using the PEDro Scale.</div></div><div><h3>Results</h3><div>19 studies that included 1292 adults fulfilled the inclusion criteria, of which 15 were randomised controlled trials and 4 non-randomised controlled trials. As for the rehabilitation modalities, 6 studies used respiratory muscle training, 6 studies used low to moderate intensity rehabilitation, 6 used high intensity rehabilitation and one used passive rehabilitation. The methods used between and within each group differed greatly, leading to an expected high heterogeneity of results. Nethertheless the random-effects model found a significant difference favouring physiotherapy (SMD -0.63, 95 CI [-1.03; −0.24], p &lt; 0.001, <em>I</em>² = 88 %). Subgroup analysis showed a significant effect in the high intensity rehabilitation group alone, with null heterogeneity.</div></div><div><h3>Conclusion</h3><div>In people suffering from dyspnoea following a SARS-CoV-2 infection, physiotherapy and especially pulmonary rehabilitation may help alleviate respiratory symptoms. Future studies will need to provide more consistent rehabilitation methods and better descriptions of them so as to reveal clear effects and avoid the confusion caused by using too many rehabilitation modalities.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"236 ","pages":"Article 107909"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of e-Health tools in the assessment of inhalation therapy adherence in patients with chronic obstructive pulmonary disease: Scoping review coupled with bibliometric analysis","authors":"Haibo Xu ,&nbsp;Xiaoke Jiang ,&nbsp;Qiuxuan Zeng ,&nbsp;Ronghua Li","doi":"10.1016/j.rmed.2024.107898","DOIUrl":"10.1016/j.rmed.2024.107898","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) is a common respiratory disorder, and the assessment of inhalation therapy adherence is an important component of management in COPD patients. The emergence of e-Health tools provides new prospects for the assessment of inhalation therapy adherence. However, there is no comprehensive summary of the application of e-Health tools in assessing inhalation therapy adherence in COPD patients.</div></div><div><h3>Objectives</h3><div>This review aims to clarify the current state, effects, benefits, and limitations of using e-Health tools in assessing inhalation therapy adherence in COPD patients and provide future directions and recommendations for development in this field.</div></div><div><h3>Methods</h3><div>This scoping review follows the 5-step framework developed by Arksey and O'Malley. Literature on the practical application of e-Health tools was systematically searched from PubMed, Embase, Web of Science, CINAHL, and Cochrane Library, spanning from inception to April 2024. Additionally, VOSviewer (version 1.6.20) was used to construct visualization maps of countries, institutions, authors, and keywords to investigate the internal relations of included literature and to explore research hotspots.</div></div><div><h3>Results</h3><div>A total of 26 studies were included. The e-Health tools mainly include electronic monitoring devices (EMDs), smartphone app, electronic prescription, and web-based tool. e-Health tools can assess inhalation therapy adherence in COPD patients in real-time and objectively, and improve inhalation therapy adherence and clinical outcomes. Bibliometric analysis indicates that there is no network of co-authorship between countries or academic organizations. Two collaborative networks have been formed centered on Greene G. EMDs and disease exacerbations are the popular research directions.</div></div><div><h3>Conclusions</h3><div>e-Health tools have a wide range of applications and promising prospects in the assessment of inhalation therapy adherence in COPD patients. In the future, it is necessary to strengthen the cooperation between countries or research institutions, explore the cost-effectiveness of e-Health tools, and improve their accessibility and usability while adopting integrated design and combining artificial intelligence to improve the effectiveness of e-Health tools in the management of COPD.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"236 ","pages":"Article 107898"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of therapies for sleep-disordered breathing in heart failure patients: A comprehensive systematic review and network meta-analysis","authors":"Yuhan Lin ,&nbsp;Ying Chen ,&nbsp;Wenqing Tu ,&nbsp;Bifang Mai ,&nbsp;Danying Guo ,&nbsp;Yuan Li ,&nbsp;Yongtong Chen ,&nbsp;Shuanglun Xie ,&nbsp;Yuyang Chen","doi":"10.1016/j.rmed.2024.107907","DOIUrl":"10.1016/j.rmed.2024.107907","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of sleep-disordered breathing (SDB) in patients with heart failure (HF) is a significant concern, leading to adverse outcomes. This network meta-analysis (NMA) is dedicated to evaluate the relative effectiveness of diverse therapeutic approaches for SDB treatments in the context of HF.</div></div><div><h3>Methods</h3><div>An extensive search up to May 19, 2023, was implemented in PubMed, Cochrane, Embase, and Web of Science to identify randomized controlled trials (RCTs). These trials compared adaptive servo ventilation (ASV), automatic positive airway pressure (APAP), Bi-level positive pressure ventilation (Bi-level PPV), continuous positive airway pressure (CPAP), and oxygen therapy against placebo or standard treatment. Key outcomes included cardiac function indicators (left ventricular ejection fraction [LVEF], plasma B-type natriuretic peptide [BNP] levels), polysomnography data (apnea-hypopnea index [AHI], Mean and Minimum Oxygen Saturation), and patient-reported quality of life measures (Epworth sleepiness scale [ESS]). A random-effects Bayesian NMA was utilized to evaluate and compare the efficacy of these interventions.</div></div><div><h3>Results</h3><div>The study revealed significant therapeutic effects of different interventions in sleep apnea patients. For patients with obstructive sleep apnea (OSA), CPAP demonstrated superior efficacy in enhancing average oxygen saturation (mean difference (MD) = 0.98; 95 % credible interval (CI) [0.07,2.09]), improving LVEF (MD = 5.66; 95 % CI [0.71, 10.08]), and reducing AHI (MD = −20.61; 95 % CI [-33.84, −9.9]). In the case of central sleep apnea (CSA), the therapeutic approaches showed varying degrees of effectiveness. CPAP proved most effective for enhancing average oxygen saturation(MD = 1.1; 95 % CI [0.26,1.98]). ASV was the most effective in lowering AHI (MD = −32.11; 95 % CI [-47.5, −17.16]), increasing lowest oxygen saturation (MD = 8.14; 95 % CI [1.72,14.92]), and enhancing LVEF (MD = 6.58; 95 % CI [0.06,12.49]).</div></div><div><h3>Conclusion</h3><div>No single SDB treatment uniformly benefits all clinical indicators in SDB and HF patients.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"236 ","pages":"Article 107907"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The accuracy and adequacy of rapid on-site evaluation conducted by trained pulmonologist on transbronchial needle aspiration samples: A systemic review and meta-analysis","authors":"Ahmed Ehab ,&nbsp;Anas Elgenidy ,&nbsp;Omar Ayman Abobakr ,&nbsp;Tareq M. Abubasheer ,&nbsp;Ramez M. Odat ,&nbsp;Mohamed M. Ghonaim ,&nbsp;Mostafa Atef Amin ,&nbsp;Yousif Ahmed Othman ,&nbsp;Ahmed Oweidah ,&nbsp;Dina Hesham Khattab ,&nbsp;Lujain Bashir Sakka Laik ,&nbsp;Mohamed Ali ,&nbsp;Ahmad Shalabi ,&nbsp;Omar Al-Mawla ,&nbsp;Heba Wagih Abdelwahab ,&nbsp;Desouki Abdelatti","doi":"10.1016/j.rmed.2024.107903","DOIUrl":"10.1016/j.rmed.2024.107903","url":null,"abstract":"<div><h3>Introduction</h3><div>The effective deployment of rapid on-site cytologic evaluation (ROSE) requires the availability of a cytologist/pathologist. Several studies investigated the capability of trained pulmonologists to assess the adequacy and validity of transbronchial needle aspiration (TBNA) samples. This study aimed to determine the validity and adequacy of ROSE by pulmonologists (P-ROSE).</div></div><div><h3>Methods</h3><div>A systematic search was conducted in Embase, Cochrane, Scopus, PubMed, and Web of Science. The validity meta-analysis was conducted using Meta-Disc software V 2.0. A bivariate model was employed to perform the analysis.</div></div><div><h3>Results</h3><div>14 studies were included in the review, and the collective sensitivity, specificity, negative likelihood ratio, and positive likelihood ratio with 95 % CI were 89.6 % (95 % CI: 0.827–0.94), 95.9 % (95 % CI: 0.845–0.999), 0.108 (95 % CI: 0.064–0.183), and 21.598 (95 % CI: 5.447–85.636) respectively. P-ROSE demonstrated high accuracy for both diagnosis (80%–89.5 %) and adequacy of 83.1 %. Also, a high K coefficient for diagnosis and adequacy with a range (0.18–0.94) and (−0.02-0.72), respectively.</div></div><div><h3>Conclusion</h3><div>Our findings showed that P-ROSE had a high sensitivity, specificity, and accuracy, which means that following a brief training session, the pulmonologists can reliably assess prepared slides from TBNA of lymph nodes and lung masses, both in terms of sample adequacy and establishing an initial diagnosis. This can be especially valuable in healthcare settings where a Pathologist/cytopathologist is not consistently available.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"236 ","pages":"Article 107903"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}