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It is uncertain if needle gauge impacts the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration of pancreatic mass lesions. Dr Madhoun from Oklahoma, USA and colleagues performed a meta-analysis to more robustly define the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration for pancreatic masses using 22 G and 25 G needles. The research team identified studies by searching 9 medical databases for reports published between 1994 and 2011, using a reproducible search strategy comprised of relevant terms. Only studies comparing the overall diagnostic accuracy of 22 G vs 25 G endoscopic ultrasound-guided needles that used surgical histology or at least 6 months clinical follow up for a gold standard were included. The doctors assessed that 2 reviewers independently scored the identified studies for methodology and abstracted pertinent data.  | | The pooled sensitivity of the 22 G needle was 0.8 | | Endoscopy |
When required, the original investigators were contacted to provide additional data. Pooling was conducted by both fixed-effects and random-effects models. The researchers evaluated 8 studies involving 1292 subjects that met the defined inclusion criteria. The team of doctors noted that tf the 1292 patients, 799 were in the 22 G group, and 565 were in the 25 G group. The pooled sensitivity and specificity of the 22 G needle were 0.8 and 1 respectively. The researchers reported that the pooled sensitivity and specificity of the 25 G needle were 0.93 and 0.97 respectively. The bivariate generalized linear random-effect model indicated that the 25 G needle is associated with a higher sensitivity but comparable specificity to the 22 G needle. Dr Madhoun's team concluded, "This meta-analysis suggests 25 G needle systems are more sensitive than 22 G needles for diagnosing pancreatic malignancy."
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