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Pulmonology Procedures |

Prevalence of Rapid On-Site Evaluation (ROSE) With Transbronchial Needle Aspiration (TBNA) and/or Endobronchial Ultrasound (EBUS) Guided TBNA of Mediastinal Lymphadenopathy

Cidney Hulett*, MD; Momen Wahidi, MD
Author and Funding Information

University of North Carolina, Chapel Hill, NC


Chest. 2012;142(4_MeetingAbstracts):917A. doi:10.1378/chest.1390263
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Abstract

SESSION TYPE: Bronchoscopy and Interventional Procedures Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Conventional or EBUS-guided TBNA are commonly employed methods to obtain diagnostic tissue from enlarged mediastinal lymph nodes. The immediate specimen evaluation by ROSE aims to both classify a specimen as adequate and to provide a preliminary diagnosis. The purported benefits of this service include: increase in procurement of technically adequate specimens, improved diagnostic yield, decrease in overall procedure time and associated costs, implications for immediate therapeutic decisions, and ability to triage specimens for additional testing. While the benefits or ROSE are abundant, its availability for bronchoscopy services has not been universal. Our study’s aim was to assess the proportion of physicians that utilize ROSE during conventional or EBUS-guided TBNA and the reasons cited by those that do not.

METHODS: A cross-sectional analysis was conducted on a group of 81 physicians attending an ACCP sponsored EBUS training course.

RESULTS: The survey response rate was 86.4%. The reported practice setting was largely private (71.43%). ROSE was reported to be used routinely during conventional or EBUS-guided TBNA by 52.94% of respondents. The most prevalent reasons for lack of use were: historically never used (43.75%), lack of staff (25.0%), not cost effective for the pathologist (12.5%), barriers created by physical location (6.25%), and pathologist lack of expertise in cytopathology (3.13%).

CONCLUSIONS: In this sample of largely private physicians, about half routinely used ROSE during conventional or EBUS-guided TBNA. In the group that did not routinely use ROSE, the predominant reasons identified were: historical lack of use, unavailability of pathology staff, and lack of financial incentive for the pathologist.

CLINICAL IMPLICATIONS: Lack of universal utilization of ROSE potentially limits the efficacy of conventional and EBUS-guided TBNA.

DISCLOSURE: The following authors have nothing to disclose: Cidney Hulett, Momen Wahidi

No Product/Research Disclosure Information

University of North Carolina, Chapel Hill, NC

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