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We read with interest the paper by Kemp and colleagues1 which utilises cumulative sum (CUSUM) to analyse the learning curves associated with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The retrospective study from five centres demonstrated that variable learning periods are required to attain proficiency in the procedure, and a pooled sensitivity of 67.4% was observed.
The authors are to be commended on using CUSUM to calculate the learning curves for EBUS-TBNA; however, several points deserve comment. First the study only includes patients undergoing EBUS-TBNA for the diagnosis or staging of lung cancer. In clinical practice, the procedure is also commonly employed for the diagnosis of isolated mediastinal lymphadenopathy, and these procedures should be incorporated in the learning process. Secondly, the …
Footnotes
Funding NN is Medical Research Council Research Training Fellow; PN is funded by a ERS Long Term Research Fellowship; SMJ is Welcome Trust Senior Research Fellow.
Competing interests None.
Provenance and peer review Not commissioned; not externally peer reviewed.