Reply from author: Systematic or targeted sampling during endobronchial ultrasound for mediastinal staging in patients with lung cancer and abnormal mediastinum
Notice bibliographique
Résumé
The author reported no conflicts of interest.The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. The author reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. We thank Drs Sanz-Santos and colleagues1Sanz-Santos J. Serra P. Rosell A. Systematic or targeted sampling during endobronchial ultrasound for mediastinal 2 staging in patients with lung cancer and abnormal mediastinum.J Thorac Cardiovasc Surg Open. 2022; 11: 346-347Scopus (1) Google Scholar for their interest and comment on our most recent publication describing the feasibility of a randomized trial comparing systematic with targeted sampling during endobronchial ultrasound for mediastinal staging.2Sullivan K.A. Farrokhyar F. Leontiadis G.I. Patel Y.S. Churchill I.F. Hylton D.A. et al.Routine systematic sampling vs. targeted sampling during endobronchial ultrasound: a randomized feasibility trial.J Thorac Cardiovasc Surg. 2022; 164: 254-261.e1Abstract Full Text Full Text PDF Scopus (4) Google Scholar We agree with the authors of the letter that any interpretation of findings should be done with caution. The authors seem concerned that we are recommending targeted sampling. However, our study only aims to assess the safety and feasibility of a larger noninferiority crossover trial comparing targeted sampling with systematic sampling. Based on our results, the trial has met all safety milestones to proceed. As such, our recommendation was that it is safe to proceed with a larger trial, rather than a recommendation to adopt targeted sampling. I am delighted to disclose to the authors that the larger trial (National Clinical Trial 04342377) has now completed accrual and the results will be reported soon. We also would like to take the opportunity to make a distinction between patients with a radiologically normal mediastinum and those with abnormal findings. The authors are concerned, and correctly so, that we are recommending targeted sampling in patients with an abnormal mediastinum. However, our trial explicitly excludes patients with abnormal computed tomography and positron emission tomography findings, and subsequently only includes patients with a Canada Lymph Node Score of 1 or less.3Hylton D.A. Turner S. Kidane B. Spicer J. Xie F. Farrokhyar F. et al.The Canada Lymph Node Score for prediction of malignancy in mediastinal lymph nodes during endobronchial ultrasound.J Thorac Cardiovasc Surg. 2020; 159: 2499-2507Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar As such, only patients with triple normal lymph nodes were included in this trial.4Hylton D.A. Kidane B. Spicer J. Turner S. Churchill I. Sullivan K. et al.Endobronchial ultrasound staging of operable non-small cell lung cancer: do triple normal lymph nodes require routine biopsy?.Chest. 2021; 156: 2470-2476Abstract Full Text Full Text PDF Scopus (7) Google Scholar Triple normal lymph nodes have a malignancy rate of 5.6%, which is close to the incidence of missed nodal metastases on the feasibility trial and pathological analyses. The authors mention that it is well known that the sensitivity of endobronchial ultrasound-guided transbronchial fine-needle aspiration decreases in this setting, which is why we hypothesize that systematic sampling may not be required. We thank the authors for their letter and look forward to discussing the results of our subsequent trial. Systematic or targeted sampling during endobronchial ultrasound for mediastinal staging in patients with lung cancer and abnormal mediastinumJTCVS OpenVol. 11PreviewIn the recently published article by Sullivan and colleagues,1 the authors describe the feasibility of a randomized controlled trial that aims to compare targeted with systematic endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA) sampling for mediastinal staging in patients with lung cancer. The authors hypothesize that targeted EBUS-TBNA sampling is not inferior to systematic EBUS-TBNA. A targeted, selected, or “hit-and-run” EBUS-TBNA sampling is defined as a specific investigation for malignancy-suspected mediastinal nodes based on positron emission tomography-computed tomography (PET-CT) findings (fluorodeoxyglucose avid or short axis ≥10 mm). Full-Text PDF Open Access
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 distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 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 tête enseignante, 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 ».