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Editorials: Point/Counterpoint Editorials |

The Value of Answering Simple Bronchoscopy Questions With Randomized Clinical TrialsEndobronchial Ultrasound Needle Biopsy Techniques

Luis Angel, MD, FCCP
Author and Funding Information

From the University of Texas Health Science Center.

Correspondence to: Luis Angel, MD, FCCP, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78229; email: angel@uthscsa.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(3):551-552. doi:10.1378/chest.12-0508
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Interventional pulmonology has matured over the last 15 years from a field with few available training programs and some controversy regarding the need for this subspecialized training to the present time, when there are currently > 17 interventional pulmonology training programs offering positions through the National Residency Match program.1 Despite this significant growth in interventional pulmonology, we have limited literature that advances this field, from reporting the experience from a few centers in one particular technique or modality—“How do I do it?”—to a scientific evidence base supported by randomized clinical trials demonstrating the indications for, and results of, commonly performed interventional procedures. A PubMed search of the term “bronchoscopy” limited to randomized clinical trials resulted in only 27 articles during the last 10 years, most of them related to the anesthesia and sedation required for flexible bronchoscopy or to procedures such as endoscopic lung volume reduction surgery and thermoplasty.25 The latter two are therapeutic options required to have randomized studies to obtain US Food and Drug Administration clearance before they can be introduced in the market. Surprisingly, there are few or no randomized studies of many of the therapeutic procedures, such as stent placement, balloon dilation, argon plasma coagulation, and cryotherapy, that are the backbone of the therapeutic arm of the interventional pulmonary specialty.

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