Learning Curves for Electromagnetic Navigation Bronchoscopy Using CUSUM Analysis

Louise L Toennesen, Helene H Vindum, Ellen Risom, Alexis Pulga, Rafi M Nessar, Arman Arshad, Alice Christophersen, Lars Konge, Paul F Clementsen

13 Citations (Scopus)

Abstract

BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) is a relatively new and technically demanding procedure for the guidance of bronchoscopic biopsy to help locate small lung lesions. The results in experienced hands are well described. However, we do not know the results in unexperienced hands-in other words, we have no knowledge about how fast you can learn the procedure.

AIM: The aim of this study was to draw learning curves for beginners in ENB using Cumulated Sum (CUSUM) analysis, a method for quantitative evaluation of the learning curves for clinical procedures.

METHODS: Four operators from 3 centers without prior ENB experience were enrolled. The outcome of consecutive ENB procedures was assessed and classified as either diagnostic or nondiagnostic based on sample adequacy. Learning curves were drawn based on diagnostic yield.

RESULTS: A total of 215 procedures were assessed. For 2 of the operators (operators 1 and 4), at least 25 to 30 procedures were necessary to obtain competency whereas operators 2 and 3 showed more horizontal learning curves indicating an overweight of diagnostic procedures from the beginning.

CONCLUSION: Operators achieve competences in ENB at different paces. This must be taken in account when beginners start to learn the procedure. There is a huge need for a structured educational program and a validated test to determine competences.

Original languageEnglish
Article numbere815
JournalJournal of Bronchology & Interventional Pulmonology
Volume29
Issue number3
Pages (from-to)164-170
Number of pages7
ISSN1944-6586
DOIs
Publication statusPublished - 1 Jul 2022

Keywords

  • invasive pulmonology
  • lung cancer
  • pulmonary nodules
  • pulmonologists
  • Electromagnetic Phenomena
  • Biopsy/methods
  • Lung Neoplasms/pathology
  • Humans
  • Bronchoscopy/methods
  • Learning Curve

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