{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:47:45Z","timestamp":1782848865661,"version":"3.54.5"},"reference-count":47,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"accepted":{"date-parts":[[2026,5,22]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Comparative evidence on the diagnostic yield of endobronchial ultrasound (EBUS)-guided sampling techniques for mediastinal lesions remains limited. We conducted a network meta-analysis (NMA) to evaluate EBUS-guided transbronchial needle aspiration (EBUS-TBNA), intranodal forceps biopsy (EBUS-IFB), transbronchial needle core biopsy (EBUS-TBNB) and transbronchial mediastinal cryobiopsy (EBUS-TMC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Random-effects NMA was performed within Bayesian and frequentist frameworks. Frequentist estimates were reported as risk ratios (RRs) with 95% CIs and, where applicable, 95% predictive intervals (PrIs). Bayesian ranking was assessed using surface under the cumulative ranking curve (SUCRA) values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>35 studies involving 3751 patients were included. EBUS-TMC (RR 1.27, 95%\u2009CI 1.16 to 1.39; 95% PrI 0.89\u20131.81)\u2009and EBUS-IFB (RR 1.21, 95%\u2009CI 1.07 to 1.38; 95% PrI 0.84\u20131.75)\u2009may provide higher diagnostic yield than EBUS-TBNA, whereas EBUS-TBNB did not show a clear advantage (RR 1.10, 95%\u2009CI 0.98 to 1.23). However, all 95% PrIs crossed unity, suggesting uncertainty about reproducibility in future settings. SUCRA rankings favoured EBUS-TMC followed by EBUS-IFB, EBUS-TBNB and EBUS-TBNA but should not be interpreted as certainty of superiority. Subgroup analyses suggested greater benefits of EBUS-TMC and EBUS-IFB in benign diseases, sarcoidosis and lymphoma but similar performance in lung cancer. Most adverse events were mild to moderate, although EBUS-TMC had a higher reported adverse-event rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EBUS-TMC and EBUS-IFB may improve diagnostic yield over EBUS-TBNA in selected diseases and experienced centres. Given the very low certainty of evidence, wide PrIs and exploratory SUCRA rankings, these findings should be viewed as hypothesis-generating rather than definitive evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420251236286.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/thorax-2025-224563","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:55:39Z","timestamp":1782845739000},"page":"thorax-2025-224563","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative performance of endobronchial ultrasound-guided sampling techniques in patients with mediastinal lesions: a network meta-analysis"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6831-3953","authenticated-orcid":false,"given":"Yan","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Chengdu Integrated TCM & Western Medicine Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8790-0930","authenticated-orcid":false,"given":"Sheng-Ping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"2026063010201561000_thorax-2025-224563v1.1","doi-asserted-by":"crossref","first-page":"107362","DOI":"10.1016\/j.lungcan.2023.107362","article-title":"Endobronchial ultrasound in diagnosing and staging of lung cancer by Acquire 22G TBNB versus regular 22G TBNA needles: A randomized clinical trial","volume":"185","author":"Kramer","year":"2023","journal-title":"Lung Cancer"},{"key":"2026063010201561000_thorax-2025-224563v1.2","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/S2213-2600(22)00392-7","article-title":"Transbronchial needle aspiration combined with cryobiopsy in the diagnosis of mediastinal diseases: a multicentre, open-label, randomised trial","volume":"11","author":"Fan","year":"2023","journal-title":"Lancet Respir 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