Interventional pulmonology: an update for internal medicine physicians.
Bibliographic record
Abstract
Interventional pulmonology is a subspecialty that uses advanced diagnostic and therapeutic procedures to care for patients with benign and malignant diseases of the lung, airways and pleura. There has been a rapid proliferation of new pulmonary procedural technologies over the last decade. Common diagnostic applications include endobronchial ultrasound, guided bronchoscopy and a number of pleural disease interventions. Endobronchial ultrasound is performed with a specially design flexible bronchoscope and allows safe and accurate sampling of intrathoracic structures through the airway wall under direct visualization. Guided bronchoscopy methods are granting significant improvement in the diagnostic yield of flexible bronchoscopy. Virtual bronchoscopy, radial probe endobronchial ultrasound and electromagnetic navigational bronchoscopy are examples of these methods. Interventional pulmonologists can also be trained to perform ultrasound guided thoracentesis, closed-needle pleural biopsy and medical thoracoscopy to help in the diagnosis of different pleural pathologies. Therapeutic applications can be used to efficiently bring symptomatic relief of benign and malignant central airway obstruction by using a myriad of flexible and rigid bronchoscopy techniques. Airway stenting and ablative techniques such as laser, electrocautery, cryosurgery and microdebrider techniques are example of resources that can be used by interventional pulmonologists for therapeutic purposes. A number of effective therapies for the management of malignant pleural disease have been studied in recent years, including chemical pleurodesis and tunnelled pleural catheters, greatly adding to our understanding of which therapy to use in which patient. In addition, flexible bronchoscopy approaches to more common disease, such as asthma and chronic obstructive pulmonary disease are currently available or are being developed. This update aims to provide the internal medicine physician with a brief overview of some of the common clinical procedures performed by interventional pulmonary specialists and the current indications and evidence for their use.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.005 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.005 |
| Insufficient payload (model declined to judge) | 0.026 | 0.025 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".