Measuring central airway obstruction. What do bronchoscopists do?

Area of Science:

• Pulmonology
• Interventional Bronchoscopy
• Medical Imaging

Background:

• Central airway obstruction (CAO) is a common challenge for bronchoscopists.
• Documenting CAO severity is crucial but lacks standardized methods.
• Axial imaging is the gold standard, yet visual estimation is widely used.

Purpose of the Study:

• To investigate bronchoscopists' opinions on assessing CAO.
• To evaluate the reliability and variability of visual estimation for CAO.

Main Methods:

• An online questionnaire was distributed to 438 members of the American Association of Bronchology and Interventional Pulmonology.
• Participants reported their practices for measuring CAO and visually estimated obstruction severity from 10 images.
• 118 responses were analyzed, assessing opinions and estimation variability.

Main Results:

• 91% of respondents use visual estimation for CAO, often with numeric estimates (87%).
• Visual estimations of airway obstruction from static images showed considerable variability among participants.
• A significant majority (86%) agreed on the need for standardized airway narrowing measurement.

Conclusions:

• The study indicates that visual estimation of CAO is subjective and highly variable among bronchoscopists.
• This subjective method is prevalent due to the lack of practical, standardized alternatives.
• Further research and development of standardized tools are necessary for accurate CAO assessment.