Research Article

*Author for correspondence:

E-mail Address: Susan.Garwood@hcahealthcare.com

Pulmonary Disease, 4230 Harding Road, Saint Thomas Health, Nashville, TN 37205, USA

^‡Current address: Pulmonary/Critical Care, Centennial Thoracic Surgical Associates, Nashville, TN 37203, USA

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Pam ClenDening

Pulmonary Disease, 4230 Harding Road, Saint Thomas Health, Nashville, TN 37205, USA

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Nathanael D Hevelone

710 Medtronic Parkway, Medtronic, Minneapolis, MN 55432, USA

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Kristin L Hood

710 Medtronic Parkway, Medtronic, Minneapolis, MN 55432, USA

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Sean Pidgeon

710 Medtronic Parkway, Medtronic, Minneapolis, MN 55432, USA

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Leonard James Wudel

Thoracic Surgery, Medical Center Boulevard, Wake Forest Baptist Health, Winston Salem, NC 27157, USA

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Published Online:29 Nov 2016https://doi.org/10.2217/lmt-2016-0015

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Abstract

Aim: To evaluate the clinical and financial impact of introducing electromagnetic navigation bronchoscopy (ENB) at a community center. Methods: This retrospective, single-arm, single-center study evaluated 90 consecutive patients who had undergone ENB in 2012. Radial probe endobronchial ultrasound was used to localize the lesion after initial ENB. ENB-aided diagnoses, follow-up procedures and treatments, and adverse events were collected through 2 years. Results: ENB was conducted for lung biopsy (86 patients), fiducial placement (five), and/or dye marking (two). ENB-aided diagnostic yield was 82.6% (71/86), including 36 malignant and 35 nonmalignant cases. NSCLC was stage I–II in 84.6%. There were four false negatives. Sensitivity and negative predictive value were 90.0 and 88.6%. Pneumothorax occurred in 6/90 (5/6 with chest tube) and minor bleeding in four. The downstream revenue of new ENB cases was US$363,654. Conclusion: ENB introduction provided high diagnostic yield, early-stage diagnosis, acceptable safety, and was financially justified.

Keywords:

Papers of particular significance to the subject have been highlighted as: • of interest; •• of considerable interest

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Vol. 5, No. 3

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Published online 29 November 2016

Published in print November 2016

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Acknowledgements

The authors thank Lynn Peterson, Kimberly Owens and Elizabeth Pace of Saint Thomas Health and Jeffrey Potkul of Medtronic for their contributions to study design and data collection.

Author contributions

SK Garwood takes responsibility for the content of the manuscript and had full access to all data. SK Garwood, P ClenDening, S Pidgeon and K Hood made substantial contributions to conception and design of the study. SK Garwood, P ClenDening and LJ Wudel were responsible for data acquisition. Data were compiled by S Pidgeon and N Hevelone and analyzed by N Hevelone. SK Garwood and K Hood drafted the manuscript. All authors critically revised the manuscript for important intellectual content and approved the final version to be published.

Disclosure

Note of Prior Abstract Publication/Presentation: CHEST 2015 (poster).

Financial & competing interests disclosure

N Hevelone, KL Hood and S Pidgeon are full-time employees of Medtronic and assisted SK Garwood in data compilation (S Pidgeon), analysis (N Hevelone) and manuscript writing (KL Hood). The study was sponsored and funded by Medtronic (Minneapolis, MN), which provided input into the study design, data analysis and manuscript writing. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Medical writing assistance was provided by KL Hood and was funded by Medtronic.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval and have followed the principles outlined in the Declaration of Helsinki. A consent waiver was granted by the institutional review board for the retrospective collection of anonymous patient data.

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Navigational bronchoscopy at a community hospital: clinical and economic outcomes

Abstract

References