Safety and accuracy of the nasal route for linear endobronchial ultrasound
Bibliographic record
Abstract
Background Linear endobronchial ultrasound (EBUS) is a safe and accurate diagnostic test for mediastinal adenopathy. Its feasibility through the nasal route has not been reported. Objective To document the feasibility of linear EBUS using the nasal route and compare its accuracy and safety with the oral route. Methods A retrospective analysis of consecutive subjects who underwent an EBUS procedure under conscious sedation at our center was conducted. Nasal insertion of the fibroscope was attempted in all subjects; the oral route was used in case of failure of nasal insertion. Characteristics of the procedure and the diagnostic accuracy of EBUS were compared between the two insertion routes. Results From May to October 2012, 209 subjects underwent an EBUS. Complete data was available for 196 subjects. Nasal insertion of the EBUS fibroscope was possible in 73.5%. There was no difference between the two insertion routes in the location and number of stations sampled per subject. Procedure duration and doses of local anesthetic were similar. Complications (epistaxis, bronchial bleeding, desaturation, pneumothorax) were similar between the two groups (2.1% in the nasal group vs 1.9% in the oral group). Minor epistaxis occurred in only one subject in the nasal group. Comparing the nasal and oral groups, rates of adequate specimens were comparable (90.5 vs 88.9%, respectively; p=0.68), and proportions of diagnostic specimens were not statistically different (51.4% vs 42.3%, respectively; p=0.26). Conclusion Linear EBUS can be performed safely via the nasal route and with comparable accuracy to the oral route. Controlled studies are required to determine which insertion route provides best patient comfort.
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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 | 0.006 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
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".