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Volume 90
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10.5603/ARM.a2022.0020
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Advances in Respiratory Medicine is published by MDPI from Volume 90 Issue 4 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Via Medica.
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Article

Diagnostic Accuracy and Adequacy of Rapid On-Site Evaluation Performed by a Pulmonologist on Transbronchial Needle Aspi-Ration Specimens (DREPA): A Prospective Study

by
Kunal Deokar
1,
Poonam Elhence
2,
Naveen Dutt
1,
Ram Niwas Jalandra
1,
Sudeep Khera
2,
Prem Prakash Sharma
3 and
Nishant Kumar Chauhan
1,*
1
Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
2
Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
3
Department of Community medicine and Family medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
*
Author to whom correspondence should be addressed.
Adv. Respir. Med. 2022, 90(2), 161-170; https://doi.org/10.5603/ARM.a2022.0020
Submission received: 23 August 2021 / Revised: 23 August 2021 / Accepted: 20 December 2021 / Published: 28 June 2022
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Abstract

Introduction: Rapid on-site evaluation (ROSE) during transbronchial needle aspiration (TBNA) is conventionally performed by pathologists. However, availability of a pathologist in the bronchoscopy suite is often an issue. We aimed to study if a pulmonologist, after receiving a short period of training in cytopathology, is able to assess the adequacy of onsite samples during TBNA. Material and methods: A pulmonologist was initially trained by a pathologist in examining cytology slides and assessing sample adequacy on TBNA smears. During TBNA, one slide from each needle pass was stained on-site using rapid Giemsa stain and was labelled as ROSE slide. The remaining slides were sent to the pathology laboratory for definitive cytological analysis. The ROSE slides were examined by a pulmonologist and a pathologist blinded to each other’s interpretation. Level of agreement between the pulmonologist and pathologist was assessed by estimating Cohen's kappa. Results: A total of 172 slides from 35 patients were prepared for ROSE and evaluated independently by pulmonologist and pathologist. For adequacy, the pulmonologist and pathologist agreed in 143 out of the 172 slides (83% agreement), κ 0.649 (p < 0.001). For diagnostic categories, the pulmonologist and the pathologist agreed in 143 out of the 172 slides (83% agreement); κ 0.696 (p < 0.001). The sensitivity, specificity and accuracy of ROSE performed by the pulmonologist with respect to that performed by the pathologist was 66.2%, 96.8% and 83.1% respectively. Conclusion: After a short period of training in cytopathology, a pulmonologist can assess for adequacy of TBNA ROSE slides in the bronchoscopy suite.
Keywords: bronchoscopy; pathologist; pulmonologist; ROSE; TBNA bronchoscopy; pathologist; pulmonologist; ROSE; TBNA

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MDPI and ACS Style

Deokar, K.; Elhence, P.; Dutt, N.; Jalandra, R.N.; Khera, S.; Sharma, P.P.; Chauhan, N.K. Diagnostic Accuracy and Adequacy of Rapid On-Site Evaluation Performed by a Pulmonologist on Transbronchial Needle Aspi-Ration Specimens (DREPA): A Prospective Study. Adv. Respir. Med. 2022, 90, 161-170. https://doi.org/10.5603/ARM.a2022.0020

AMA Style

Deokar K, Elhence P, Dutt N, Jalandra RN, Khera S, Sharma PP, Chauhan NK. Diagnostic Accuracy and Adequacy of Rapid On-Site Evaluation Performed by a Pulmonologist on Transbronchial Needle Aspi-Ration Specimens (DREPA): A Prospective Study. Advances in Respiratory Medicine. 2022; 90(2):161-170. https://doi.org/10.5603/ARM.a2022.0020

Chicago/Turabian Style

Deokar, Kunal, Poonam Elhence, Naveen Dutt, Ram Niwas Jalandra, Sudeep Khera, Prem Prakash Sharma, and Nishant Kumar Chauhan. 2022. "Diagnostic Accuracy and Adequacy of Rapid On-Site Evaluation Performed by a Pulmonologist on Transbronchial Needle Aspi-Ration Specimens (DREPA): A Prospective Study" Advances in Respiratory Medicine 90, no. 2: 161-170. https://doi.org/10.5603/ARM.a2022.0020

APA Style

Deokar, K., Elhence, P., Dutt, N., Jalandra, R. N., Khera, S., Sharma, P. P., & Chauhan, N. K. (2022). Diagnostic Accuracy and Adequacy of Rapid On-Site Evaluation Performed by a Pulmonologist on Transbronchial Needle Aspi-Ration Specimens (DREPA): A Prospective Study. Advances in Respiratory Medicine, 90(2), 161-170. https://doi.org/10.5603/ARM.a2022.0020

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