Endoscopic Ultrasound in Nova Scotia: A Quality Assurance Study
Notice bibliographique
Résumé
Introduction: Since the single most important function of EUS is in its ability to obtain tissue via FNA, our primary outcome measure will be yield of FNA for the various indications. Secondary outcome measures will include the indications, complications and waiting time. We also compared the diagnostic yield of FNA with and without having Rapid on-site Evaluation (ROSE). This quality assurance study will help in improving the EUS program in our province. Methods: It is an observational, retrospective cohort study of all the men and women who had undergone EUS in Nova Scotia. Subjects of this research consist of 176 patients. 114 EUS reports, including 52 FNA without ROSE, will be analyzed to determine the reason for referral to EUS, the complications if any, and the waiting time for an EUS appointment in the out patients sittings. Results of EUS with or without FNA will be charted as well as the diagnosis obtained via cytological analysis. Another 60 EUS reports were FNA was taken with ROSE, were analyzed and diagnostic yields were charted and compared with the FNAs without ROSE. Results: The most common reasons for referral to EUS were for evaluation of pancreatic mass/cyst, mediastinal mass/lymph node and assessment of sub-mucosal lesions. Other indications were dilated CBD, pancreatic cancer screening, chronic unexplained pancreatitis. A total of 110 FNA's (52 without ROSE, and 60 with ROSE) were performed by EUS for different indications; most of them were from a pancreatic mass/cyst, Lymph node and submucosal lesions. In the FNAs without ROSE, 86% of results were conclusive, compared to 82% with ROSE. Among the FNA obtained from a solid pancreatic mass, 88% were conclusive without ROSE compared to 86% with ROSE. The most common abnormal FNA results from the pancreas were pancreatic adenocarcinoma. Other results included pancreatic lymphoma, metastatic malignancy from lymph node FNA, and lung cancer. 2 patients (1.7%) developed complications post EUS/FNA. Conclusion: EUS can be used for variety of indications, most commonly to further characterize a pancreatic lesion, with the ability of obtaining a tissue diagnosis through FNA with good diagnostic yield that guided patients management. It is a minimally invasive procedure with low complication rate. In our observational study, ROSE didn't increase the diagnostic yield of FNA, although further studies with RCT needed to establish the efficacy of ROSE in sensitivity and specificity as well.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».