{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T20:16:32Z","timestamp":1787861792846,"version":"build-2784847793"},"reference-count":54,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;\/i&gt;&lt;\/b&gt; Surgical lung biopsy (SLB) is performed in patients with acute respiratory distress syndrome (ARDS); however, its clinical utility remains unclear. &lt;b&gt;&lt;i&gt;Objectives:&lt;\/i&gt;&lt;\/b&gt; We categorized the pathological diagnoses and investigated the predictive value for short-term mortality. &lt;b&gt;&lt;i&gt;Method:&lt;\/i&gt;&lt;\/b&gt; Three electronic databases (MEDLINE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) were searched for the included studies. The QUADAS-2 was used to evaluate the risk of bias and its applicability. The types and populations of pathological diagnoses were investigated. The pooled sensitivity, positive likelihood ratio (LR+), negative likelihood ratio (LR\u2212), and diagnostic odds ratio (DOR) were estimated at a fixed specificity. Hierarchical summary receiver operating characteristic curves were drawn. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; A total of 16 studies that enrolled 758 patients were included. The pathological diagnoses were as follows: diffuse alveolar damage (DAD) 29.9%; infection 24.7%; interstitial lung disease 17.2%; malignancy 3.6%; cardiovascular disease 3.6%; drug toxicity 2.3%; connective tissue disease 2.2%; allergic disease 1.1%; and nonspecific diagnosis 15.4%. To predict short-term mortality, 13 studies that enrolled 613 patients used DAD as an index test and recorded a mortality rate of 56.9% (349 of 613 patients). A total of 3 studies that used index tests other than DAD were excluded. The pooled sensitivity, fixed specificity, LR+, LR\u2212, and DOR were 0.46 (95% confidence interval [CI]: 0.29\u20130.56), 0.69, 1.48 (95% CI: 0.92\u20131.81), 0.78 (95% CI: 0.63\u20131.03), and 1.90 (95% CI: 0.89\u20132.86), respectively. &lt;b&gt;&lt;i&gt;Conclusions:&lt;\/i&gt;&lt;\/b&gt; SLB is unlikely to provide a specific diagnosis and should not be recommended for confirming DAD or predicting ARDS prognosis. <\/jats:p>","DOI":"10.1159\/000519675","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T22:01:09Z","timestamp":1638309669000},"page":"422-432","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Utility of Surgical Lung Biopsy for Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis"],"prefix":"10.1159","volume":"101","author":[{"given":"Hiroyuki","family":"Hashimoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0962-5184","authenticated-orcid":false,"given":"Yoshihiro","family":"Suido","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3015-3820","authenticated-orcid":false,"given":"Erina","family":"Tabata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Okamori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuo","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Ando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigenori","family":"Yoshitake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-476X","authenticated-orcid":false,"given":"Yohei","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.101691"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.06.019"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2018.01.007"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.125.1.197"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.5669"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2018.07.002"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1683996"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000000373"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1097\/CNQ.0000000000000282"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1590\/s1807-59322006000500009"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2016.346"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-12-116"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.19163"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201308-1483ST"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-019-0724-x"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.13257"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1378\/chest.86.5.671"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/s0025-6196(12)60872-6"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(75)90256-9"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201211-1981OC"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06036-z"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0488"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0043347"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0073099"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1159\/000076670"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201710-1967CI"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-991526"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00298303"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-020-01203-w"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1159\/000514822"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1016\/s0003-4975(00)01913-5"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.49.3225"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7403.1358"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1023\/b:ifla.0000049049.81688.fe"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-009-0243-6"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-120-8-199404150-00008"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-2-9"},{"key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