title: Transbronchial needle aspiration with rapid on-site evaluation: a prospective study on efficacy, feasibility and cost effectiveness.
abstract: BACKGROUND
  Transbronchial needle aspiration (TBNA) has an established role in diagnosis of hilar and mediastinal lesions. Rapid on-site evaluation (ROSE) of TBNA smears can determine the adequacy of TBNA smears that can obviate the need for repeat procedures, thus avoiding added cost. There is paucity of data from India showing efficacy and cost-effectiveness of ROSE. Hence, this study was carried out to assess the efficacy, feasibility and cost implications of ROSE assisted TBNA.
  
  
  METHODS
  Forty consecutive patients undergoing TBNA were enrolled and ROSE was performed on TBNA smears. The results were analysed using a comparative study design.
  
  
  RESULTS
  It was found that 45% of patients would have required a repeat bronchoscopy due to inadequacy of material, if ROSE was not used. Inadequate smears were more common in benign aetiologies than malignant ones. TBNA of mass lesions and lesions with endoluminal bulge give better results than TBNA of lymph nodes and without endoluminal bulge.
  
  
  CONCLUSIONS
  ROSE was found to increase the yield of TBNA and help to prevent repeat procedures. It proved to be simple, cost-effective and feasible in Indian settings.
authors.affiliation: Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, HIHT University, Dehradun (Uttarakhand), India. girish_sindhwani@rediffmail.com
authors.forename: Girish
authors.initials: G
authors.lastname: Sindhwani
authors.affiliation: Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, HIHT University, Dehradun (Uttarakhand), India.
authors.forename: Jagdish
authors.initials: J
authors.lastname: Rawat
authors.affiliation: Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, HIHT University, Dehradun (Uttarakhand), India.
authors.forename: Smita
authors.initials: S
authors.lastname: Chandra
authors.affiliation: Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, HIHT University, Dehradun (Uttarakhand), India.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Kusum
authors.affiliation: Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, HIHT University, Dehradun (Uttarakhand), India.
authors.forename: Manvinder
authors.initials: M
authors.lastname: Rawat
mesh_terms: D001707:Biopsy, Needle / Q000191:economics / Q000379:methods*; D001999:Bronchoscopy / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis*; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results