Respiratory Endoscopy: Diagnostic Yield, Technical Factors and Complications
Condition: Lung Neoplasm; Lung Diseases, Interstitial; Respiratory Tract Infections; Pleural Effusions
MeSH terms: Respiratory Tract Infections; Lung Neoplasms; Lung Diseases; Pleural Effusion; Lung Diseases, Interstitial
Study type: Observational

Summary: 
      Background: Respiratory endoscopy comprises flexible bronchoscopy and medical thoracoscopy.
      The diagnostic yield, technical factors and complications for all patient sub-populations is
      still not clearly defined. This may result in inappropriate or even dangerous application of
      such procedures. The aim of the study is to collect data on these aspects of respiratory
      endoscopy and identify important trends, as well as, areas for improvement. This data will
      also provide baseline comparative data for new bronchoscopic techniques such as endobronchial
      ultrasound and navigational bronchoscopy.

      Method: Prospective data collection. Technical details regarding these procedures are
      currently keyed into the OTM system by the endoscopy operators for documentation and billing.
      The department of Respiratory and Critical Care Medicine gets monthly downloads of all the
      fields from the OTM system for audit purposes.(See data collection form) The research project
      proposes to make the data non identifiable by removing the patient's name and IC number.
      Additionally the yield of the procedure will be checked by a chart review of the histology
      and microbiology results. There are no restrictions on patient recruitment because all
      procedures will be performed for clinical indications only and no patient will be recruited
      for the sole purpose of the study. Waiver of consent has been approved by the IRB.
    

Detailed description: 
      Background: Respiratory endoscopy comprises flexible bronchoscopy and medical thoracoscopy.
      The diagnostic yield, technical factors and complications for all patient sub-populations is
      still not clearly defined. This may result in inappropriate or even dangerous application of
      such procedures. The aim of the study is to collect data on these aspects of respiratory
      endoscopy and identify important trends, as well as, areas for improvement. This data will
      also provide baseline comparative data for new bronchoscopic techniques such as endobronchial
      ultrasound and navigational bronchoscopy.

      Method: Prospective data collection. Technical details regarding these procedures are
      currently keyed into the OTM system by the endoscopy operators for documentation and billing.
      The department of Respiratory and Critical Care Medicine gets monthly downloads of all the
      fields from the OTM system for audit purposes.(See data collection form) The research project
      proposes to make the data non identifiable by removing the patient's name and IC number.
      Additionally the yield of the procedure will be checked by a chart review of the histology
      and microbiology results. There are no restrictions on patient recruitment because all
      procedures will be performed for clinical indications only and no patient will be recruited
      for the sole purpose of the study. Waiver of consent has been obtained by the IRB. The
      current estimated bronchoscopy load is 1000/year and data will be kept in the trial
      co-coordinator's computer in a locked office. The investigators hope to run the database for
      3 years initially.
    

Intervention name(s): Respiratory endoscopy
Intervention type(s): Procedure
Intervention description(s): Bronchoscopy, thoracoscopy, endobronchial ultrasound
Other intervention name(s): Bronchoscopy-Flexible bronchoscopy; Thoracoscopy-Pleuroscopy; Endobronchial ultrasound-EBUS
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        All patients undergoing respiratory endoscopy at Singapore General Hospital
      
Keywords: Bronchoscopy; Thoracoscopy