Table 2

 Summary of results*

Median sensitivity (IQR)Median specificity (IQR)¶Pooled sensitivity(95% CI)†Pooled specificity(95% CI)† ¶Likelihood ratio (95% CI)‡ ¶
IQR, interquartile range.
*For studies that did not use real-time radiological guidance for needle placement.
†Pooled sensitivity and specificity were calculated using a random effects model.
‡Positive and negative likelihood ratios were calculated from the pooled sensitivity and specificity.
§p value for the comparison between tier 1 and non-tier 1 studies.
¶Median and pooled specificities for non-tier 1 studies were not calculated because only two studies allowed calculation of specificity (both 100%);33,37 however, both of these studies had fewer than 10 patients without mediastinal metastases. We were thus unable to calculate likelihood ratios for non-tier 1 studies.
Tier 1 studies0.36 (0.32–0.38)0.98 (0.96–1.00)0.39 (0.17 to 0.61)0.99 (0.96 to 1.00)29.0 (21.9 to 38.4)0.62 (0.53 to 0.72)
Non-tier 1 studies0.82 (0.79–0.84)0.78 (0.71 to 0.84)
p value§0.0010.009