Diagnostic Performance and Safety Profile of Robotic-assisted Bronchoscopy: A Systematic Review and Meta-Analysis
Abstract
RATIONALE
Conventional electromagnetic navigation (ENB) and other guided bronchoscopic modalities have a very desirable safety profile but their diagnostic yield is only 60-70% for pulmonary lesions. Recently, robotic-assisted bronchoscopy (RAB) platforms have been introduced to improve the diagnostic performance of bronchoscopic modalities.
OBJECTIVES
To determine the diagnostic performance and safety profile of RAB (shape-sensing and electromagnetic navigation-based platforms), by performing a systematic review and meta-analysisMethods: PubMed, Embase, and Google Scholar databases were searched to find studies that had reported on the diagnostic performance and/or the safety profile of one of the RAB systems. The quality of included studies was assessed using the QUADAS-2 tool. Meta-analysis was performed using MedCalc version 20.118. Pooled diagnostic yield was calculated using a Freeman-Tukey transformation. We planned to use random effects model if the I² index was > 40%.
RESULTS
25 studies were included in our study: 20 (diagnostic and safety analyses), 5 (only safety analysis). The pooled diagnostic yield of RAB (20 studies, 1779 lesions) was 84.3% (95% CI 81.1-87.2). I2 index was 65.6%. Based on our subgroup analyses the heterogeneity was likely driven by the differences in the study designs (prospective vs. retrospective) and procedural protocols (such as different RAB systems). Lesion size > 2cm, presence of a CT-bronchus sign, and concentric radial-EBUS view were…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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