Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.
Respir Med. 2009 Jun;103(6):888-94. doi: 10.1016/j.rmed.2008.12.012.
The choice of sampling techniques in bronchoscopy with sampling from a visible lesion will depend on the expected diagnostic yields and the costs of the sampling techniques.
The aim of this study was to determine the most economical combination of sampling techniques when approaching endobronchial visible lesions.
A cost minimization analysis was performed. All bronchoscopies from 2003 and 2004 at Haukeland university hospital, Bergen, Norway, were reviewed retrospectively for diagnostic yields. 162 patients with endobronchial disease were included. Potential sampling techniques used were biopsy, brushing, endobronchial needle aspiration (EBNA) and washings. Costs were estimated based on registration of equipment costs and personnel costs. Sensitivity analyses were performed to determine threshold values.
The combination of biopsy, brushing and EBNA was the most economical strategy with an average cost of Euro 893 (95% CI: 657, 1336). The cost of brushing had to be below Euro 83 and it had to increase the diagnostic yield more than 2.2%, for biopsy and brushing to be more economical than biopsy alone. The combination of biopsy, brushing and EBNA was more economical than biopsy and brushing when the cost of EBNA was below Euro 205 and the increase in diagnostic yield was above 5.2%.
In the current study setting, biopsy, brushing and EBNA was the most economical combination of sampling techniques for endobronchial visible lesions.
支气管镜检查时，对于可见病变的采样技术选择将取决于预期的诊断收益和采样技术的成本。
本研究旨在确定在处理可见的支气管内病变时，最具经济性的采样技术组合。
进行成本最小化分析。对 2003 年至 2004 年在挪威卑尔根的豪克兰大学医院进行的所有支气管镜检查进行回顾性诊断收益分析。共纳入 162 例支气管内疾病患者。潜在的采样技术包括活检、刷检、支气管内针吸（EBNA）和灌洗。根据设备成本和人员成本的登记来估算成本。进行敏感性分析以确定阈值。
活检、刷检和 EBNA 的联合是最具经济性的策略，平均成本为 893 欧元（95%CI：657，1336）。刷检的成本必须低于 83 欧元，并且必须使诊断收益增加超过 2.2%，才能使活检和刷检比单独活检更具经济性。当 EBNA 的成本低于 205 欧元且诊断收益增加超过 5.2%时，活检、刷检和 EBNA 的联合比活检和刷检更具经济性。
在当前的研究环境中，活检、刷检和 EBNA 是处理可见支气管内病变最具经济性的采样技术组合。
