Table 3.
Summary of findings.
| Patients/populations | ARDS or acute respiratory failure | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Settings | ICU or OR | ||||||||
| Intervention | SLB (OLB or VATS) | ||||||||
| Study design | Cohort study | ||||||||
| Outcomes | No. of participants (studies) | Frequency (95% CI) | Frequency per 1000 patients (95% CI) | Factors that may decrease the quality of evidence | Quality of evidence (GRADE) | ||||
| Risk of bias | Indirectness | Inconsistency | Imprecision | Publication bias | |||||
| Biopsy-related death | 502 (11) | 0.000% (0.000–0.206%) | 0 (0–2) | Very seriousc | Not serious | Not serious (I2 = 0.0%) | Seriouse | Not applicable | Low |
| Respiratory failure | 277 (5) | 1.303% (0.000–5.692%) | 13 (0–57) | Very seriousc | Not serious | Very serious (I2 = 69.7%) | Seriouse | Not applicable | Very low |
| Cardiac complication | 414 (7) | 1.027% (0.000–3.727%) | 10 (0–37) | Very seriousc | Not serious | Serious (I2 = 60.1%) | Seriouse | Not applicable | Very low |
| Bleeding | 453 (10) | 1.460% (0.163–3.556%) | 15 (2–36) | Very seriousc | Not serious | Not serious (I2 = 25.1%) | Seriouse | Not applicable | Low |
| Other major complicationsa | 46 (2) | 4.255% (0.000–13.02%) | 43 (0–130) | Seriousd | Not serious | Not serious (I2 = 0.0%) | Very seriouse,f | Not applicable | Low |
| Pneumothorax | 337 (8) | 6.506% (1.886–13.03%) | 65 (19–130) | Very seriousc | Not serious | Very serious (I2 = 70.0%) | Very seriouse,f | Not applicable | Very low |
| Infection | 159 (3) | 2.704% (0.000–12.56%) | 27 (0–126) | Very seriousc | Not serious | Very serious (I2 = 76.8%) | Very seriouse,f | Not applicable | Very low |
| Other minor complicationsb | 511 (10) | 16.42% (9.712–24.34%) | 164 (97–243) | Very seriousc | Not serious | Very serious (I2 = 77.7%) | Seriousf | Not applicable | Very low |
ARDS, acute respiratory distress syndrome; ICU, intensive care unit; OR, operating room; SLB, surgical lung biopsy; OLB, open lung biopsy; VATS, video-assisted thoracoscopic surgery; CI, confidence interval; GRADE, grading of recommendations, assessment, development, and evaluation.
Persistent air leak that required surgery.
Persistent air leak that did not require surgery, subcutaneous emphysema, and bronchopleural fistula.
We judged this component as very serious because more than two-thirds of the studies were considered to have a high or unclear risk of bias in half of the items in the McMaster Quality Assessment Scale for Harms.
We judged this component as serious because a certain number of studies were considered to have a high or unclear risk of bias in the items in the McMaster Quality Assessment Scale for Harms.
Downgrade due to number of participants was less than optimal information size.
Downgrade due to the possibility of a change in clinical action at the upper versus lower of the confidence interval.