{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T14:18:26Z","timestamp":1783520306607,"version":"3.55.0"},"reference-count":13,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Excellence & Innovation Initiative of China-Japan Friendship Hospital","award":["ZRZC2025-XYA01"],"award-info":[{"award-number":["ZRZC2025-XYA01"]}]},{"name":"National High-Level Hospital Clinical Research Funding","award":["2025-NHLHCRF-JBGS-A-WZ-14"],"award-info":[{"award-number":["2025-NHLHCRF-JBGS-A-WZ-14"]}]},{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2024ZD0522800"],"award-info":[{"award-number":["2024ZD0522800"]}]},{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2024ZD0522804"],"award-info":[{"award-number":["2024ZD0522804"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,23]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Rigid thoracoscopy is an established diagnostic instrument for pleural diseases; however, it is limited by challenges related to manoeuvrability, patient comfort and operator learning curve. A novel dual-function semi-rigid thoracoscope with associated semi-rigid forceps has been engineered to integrate the diagnostic efficacy of rigid biopsy forceps with the ergonomic advantages of a semi-rigid system. The Dual-functIon Semi-rigid thoraCoscOpy Versus rigid thoracoscopy for the diagnosis of plEuRal disease trial was designed to evaluate whether this device achieves a diagnostic yield that is non-inferior to that of traditional rigid thoracoscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This study is designed as a prospective, randomised, open-label, controlled, non-inferiority trial. A cohort of 92 patients presenting with undiagnosed exudative pleural effusion across five centres in China will be randomly allocated to undergo pleural biopsy using either a dual-function semi-rigid thoracoscope or a conventional rigid thoracoscope. The primary endpoint of the study is the diagnostic yield. The key secondary endpoints include procedural analgesic requirements, specimen quality, operator-assessed device performance, postprocedural pain and safety. A non-inferiority margin of 10% will be applied, with analyses conducted on both the intention-to-treat and per-protocol populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study protocol was approved by the Ethics Committee of China-Japan Friendship Hospital (2026-KY-033). Written informed consent will be obtained from all participants before enrolment. The trial will be conducted in compliance with the Declaration of Helsinki and Good Clinical Practice guidelines. The results will be submitted for publication in a peer-reviewed journal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT07114783\">NCT07114783<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-118022","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:30:41Z","timestamp":1783517441000},"page":"e118022","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic yield and safety of Dual-functIon Semi-rigid thoraCoscOpy Versus rigid thoracoscopy for the diagnosis of plEuRal disease (DISCOVER-2): protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct07114783","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Li","family":"Xu","sequence":"first","affiliation":[{"name":"Shandong Public Health Clinical Center, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Second People\u2019s Hospital of Gansu Province, Lanzhou, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haihong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Hainan Affiliated Hospital of Hainan Medical University, Hainan General Hospital, Haikou, Hainan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhibin","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The Central Hospital of Xiaogan, Xiaogan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaige","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Respiratory Health and Multimorbidity; Department of Pulmonary and Critical Care Medicine, West China Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingming","family":"Deng","sequence":"additional","affiliation":[{"name":"National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1711-6328","authenticated-orcid":false,"given":"Ziwen","family":"Zheng","sequence":"additional","affiliation":[{"name":"National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3438-1764","authenticated-orcid":false,"given":"Gang","family":"Hou","sequence":"additional","affiliation":[{"name":"National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2026070806302152000_16.7.e118022.1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.98.11010213"},{"key":"2026070806302152000_16.7.e118022.2","doi-asserted-by":"publisher","DOI":"10.1159\/000158545"},{"key":"2026070806302152000_16.7.e118022.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)60212-2"},{"key":"2026070806302152000_16.7.e118022.4","first-page":"ii54","article-title":"Local anaesthetic thoracoscopy: British Thoracic Society Pleural Disease Guideline 2010","volume":"65 Suppl 2","author":"Rahman","year":"2010","journal-title":"Thorax"},{"key":"2026070806302152000_16.7.e118022.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12890-016-0258-5","article-title":"Intra-patient comparison of parietal pleural biopsies by rigid forceps, flexible forceps and cryoprobe obtained during medical thoracoscopy: a prospective series of 80 cases with pleural effusion","volume":"16","author":"Wurps","year":"2016","journal-title":"BMC Pulm Med"},{"key":"2026070806302152000_16.7.e118022.6","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000059"},{"key":"2026070806302152000_16.7.e118022.7","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02738"},{"key":"2026070806302152000_16.7.e118022.8","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.e7586","article-title":"SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials","volume":"346","author":"Chan","year":"2013","journal-title":"BMJ"},{"key":"2026070806302152000_16.7.e118022.9","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/LBR.0000000000000920","article-title":"Reporting Standards for Diagnostic Testing: Guidance for Authors From Editors of Respiratory, Sleep, and Critical Care Journals","volume":"30","author":"Ost","year":"2023","journal-title":"J Bronchology Interv Pulmonol"},{"key":"2026070806302152000_16.7.e118022.10","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12066"},{"key":"2026070806302152000_16.7.e118022.11","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1111\/crj.12256","article-title":"Feasibility and safety of parietal pleural cryobiopsy during semi-rigid thoracoscopy","volume":"10","author":"Rozman","year":"2016","journal-title":"Clin Respir J"},{"key":"2026070806302152000_16.7.e118022.12","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1097\/JS9.0000000000002165","article-title":"Comparison of thoracoscopic-guided intercostal nerve block and ultrasound-guided intercostal nerve block in postoperative analgesia of uniportal video-assisted lobectomy: a pilot randomized controlled trial","volume":"111","author":"Li","year":"2025","journal-title":"Int J Surg"},{"key":"2026070806302152000_16.7.e118022.13","doi-asserted-by":"publisher","DOI":"10.1378\/chest.108.2.324"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-118022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:30:43Z","timestamp":1783517443000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-118022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":13,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,8]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjopen-2026-118022"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-118022","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}