Comparison of Diagnostic Bronchoscopy Single-Arm Trials Using an Advanced Optimization Approach for Indirect Comparisons with Partial Individual Patient Data.
Document Type
Article
Publication Date
2025
Publication Title
Respiration
Abstract
INTRODUCTION: The diagnostic yield of lung biopsy modalities is often compared using data from single-arm studies. These comparisons are biased due to differences in study populations, institutional practices, and diagnostic yield definitions. While individual patient data may be useful to account for some of these co-variables, individual patient data may only be available for one study. What is the difference in the primary outcome between two single-arm studies that utilized different bronchoscopy technologies?
METHODS: A matching-adjusted indirect comparison analysis was performed comparing individual patient data from a retrospective multicenter cohort of consecutive RAB procedures to aggregate patient data in a prospective, multicenter clinical study of ENB procedures. The diagnostic yield was first calculated with the definition used in the comparator study, determined at 12 months after initial biopsy, with lost to follow-up excluded from the denominator (method 1), and second with a strict definition, determined at the time of bronchoscopy and nonspecific benign findings excluded (method 2).
RESULTS: Using method 1, the weighted diagnostic yield for RAB (87.1%) was significantly higher than for ENB (72.9%) (p < 0.001). Using method 2, the weighted diagnostic yield for RAB (64.9%) was also significantly higher than for ENB (50.6%) (p = 0.001).
CONCLUSIONS: An optimization-based weighting approach for indirect comparisons between single-arm studies confirmed a significantly higher diagnostic yield for RAB compared to ENB. When using method 2, it was demonstrated that various factors significantly influence the diagnostic yield of RAB, highlighting the need for balancing to mitigate confounding effects, and ideally, randomized controlled trials.
First Page
1
Last Page
10
Recommended Citation
Vachani A, Murgu S, Maldonado F, Laxmanan B, Amos TB, Zhou M, et al [Cumbo-Nacheli G]. Comparison of diagnostic bronchoscopy single-arm trials using an advanced optimization approach for indirect comparisons with partial individual patient data. Respiration. 2025. doi: 10.1159/000547686. PMID: 40730137
DOI
10.1159/000547686
ISSN
1423-0356
PubMed ID
40730137