RT Journal Article
SR Electronic
T1 Performance monitoring of EBUS for the staging and diagnosis of lung cancer: auditing the Greater Manchester EBUS service against new national standards
JF BMJ Open Respiratory Research
JO BMJ Open Resp Res
FD British Thoracic Society
SP e000777
DO 10.1136/bmjresp-2020-000777
VO 8
IS 1
A1 Anshu Punjabi
A1 Haider Al-Najjar
A1 Benjamin Teng
A1 Zoe Borrill
A1 Louise Brown
A1 Thapas Nagarajan
A1 Joanna Gallagher
A1 Seamus Grundy
A1 Ram Sundar
A1 Coral Higgins
A1 David Shackley
A1 Nicola Sinnott
A1 Haval Balata
A1 Judith Lyons
A1 Julie Martin
A1 Christopher Brocklesby
A1 Phil Crosbie
A1 Richard Booton
A1 Matthew Evison
YR 2021
UL http://bmjopenrespres.bmj.com/content/8/1/e000777.abstract
AB Introduction Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a pivotal test in lung cancer staging and diagnosis, mandating robust audit and performance monitoring of EBUS services. We present the first regional cancer alliance EBUS performance audit against the new National EBUS specification.Methods Across the five EBUS centres in the Greater Manchester Cancer Alliance, data are recorded at the point of procedure, when pathological results are available and at 6 months postprocedure to review any further pathological sampling (eg, at surgical resection) and the outcome of clinical–radiological follow-up. Outcomes across all five centres were compared with national standards for all lung cancer EBUS procedures from 01 January 2017 to 31 December 2018.Results 1899 lung cancer staging or diagnostic EBUS procedures were performed across the five centres during the study period; 1309 staging EBUS procedures and 590 diagnostic EBUS procedures. Major complications were seen in six cases (<1%). All five trusts demonstrated performance above that set national standards in key metrics for both staging and diagnostic EBUS, however the provision of adequate tissue for predictive marker testing was below national standards at one trust. Across Greater Manchester, 72% and 64% of patients had their EBUS procedure performed within 7 days of referral in 2017 and 2018, respectively. Only one out of five trusts met the national targets of >85% of procedures performed within 7 days of referral.Conclusion The National EBUS service specification is an important framework to drive the quality of EBUS services across the UK. Our data provide assurance of appropriate performance and safety while also highlighting specific areas for attention that can be addressed with the support of the cancer alliance.All data relevant to the study are included in the article or uploaded as supplemental information.