Endobronchial ultrasound-guided transbronchial needle aspiration: performance of biomedical scientists on rapid on-site evaluation and preliminary diagnosis

Objectives: Rapid on-site evaluation (ROSE) of endobronchial ultrasound-guided transbronchial needle aspiration
(EBUS-TBNA) followed by a subsequent preliminary adequacy assessment and a preliminary diagnosis,
was performed at Aarhus University Hospital by biomedical scientists (BMS). The aim of this study was to
evaluate the BMS accuracy of ROSE adequacy assessment, the preliminary adequacy assessment and the
preliminary diagnosis as compared with the cytopathologist-rendered final adequacy assessment and final
diagnosis.
Methods: The BMS-rendered assessments for 717 sites from 319 consecutive patients over a 4-month period
were compared with the cytopathologist-rendered assessments.
Comparisons of adequacy and preliminary diagnoses were based on inter-observer Cohen’s Kappa coefficient
with a 95% confidence interval (CI).
Results: Strong correlations between ROSE and final adequacy assessments [Kappa coefficient of 0.90
(CI: 0.85–0.96)] and between the preliminary and final adequacy assessments [Kappa coefficient of 0.93
(CI: 0.87–0.99)] were found. As for the correlation between the preliminary and final diagnoses, the Kappa
coefficient was 0.99 (CI: 0.98–1).
Conclusion: Both ROSE and preliminary adequacy assessments as well as preliminary diagnoses, all
performed by BMS, were highly accurate when compared with the final assessment by the cytopathologist.