医学
病变
支气管镜检查
接收机工作特性
放射科
支气管
肺
超声波
试验预测值
曲线下面积
核医学
呼吸道疾病
病理
内科学
作者
Takayasu Itō,Yuji Matsumoto,Shotaro Okachi,Kazuki Nishida,Midori Tanaka,Tatsuya Imabayashi,Takaaki Tsuchida,Naozumi Hashimoto
出处
期刊:Respiration
[S. Karger AG]
日期:2022-01-01
卷期号:101 (12): 1148-1156
被引量:1
摘要
<b><i>Background:</i></b> Several factors have been reported to affect the diagnostic yield of bronchoscopy with radial endobronchial ultrasound (R-EBUS) for peripheral pulmonary lesions (PPLs). However, it is difficult to accurately predict the diagnostic potential of bronchoscopy for each PPL in advance. <b><i>Objectives:</i></b> Our objective was to establish a predictive model to evaluate the diagnostic yield before the procedure. <b><i>Method:</i></b> We retrospectively analysed consecutive patients who underwent diagnostic bronchoscopy with R-EBUS between April 2012 and October 2015. We assessed the factors that were predictive of successful bronchoscopic diagnosis of PPLs with R-EBUS using a multivariable logistic regression model. The accuracy of the predictive model was evaluated using the receiver operator characteristic area under the curve (ROC AUC). Internal validation was analysed using 10-fold stratified cross-validation. <b><i>Results:</i></b> We analysed a total of 1,634 lesions; the median lesion size was 25.0 mm. Of these, 1,138 lesions (69.6%) were successfully diagnosed. In the predictive logistic model, significant factors affecting the diagnostic yield were lesion size, lesion structure, bronchus sign, and visible on chest X-ray. The predictive model consisted of seven factors: lesion size, lesion lobe, lesion location from the hilum, lesion structure, bronchus sign, visibility on chest X-ray, and background lung. The ROC AUC of the predictive model was 0.742 (95% confidence interval: 0.715–0.769). Internal validation using 10-fold stratified cross-validation revealed a mean ROC AUC of 0.734. <b><i>Conclusions:</i></b> The predictive model using the seven factors revealed a good performance in estimating the diagnostic yield.
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