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Data on how sensitivity varies with tumour type is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Systematic review using PubMed was performed through August 2020 to determine the sensitivity of thoracentesis and thoracoscopy for MPE secondary to malignancy, by cancer type, and complication rates. Tests to identify sources of heterogeneity were performed. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 and National Institutes of Health quality assessment tools. Publication bias was tested using funnel plots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Meta-analyses for sensitivity of thoracentesis for MPE secondary to malignancy, mesothelioma and lung and breast cancer included 29, eight, 12 and nine studies, respectively. Pooled sensitivities were 0.643 (95% CI 0.592\u20130.692), 0.451 (95% CI 0.249\u20130.661), 0.738 (95% CI 0.659\u20130.836) and 0.820 (95% CI 0.700\u20130.917), respectively. For sensitivity of thoracoscopy for MPE secondary to malignancy and mesothelioma, 41 and 15 studies were included, respectively. Pooled sensitivities were 0.929 (95% CI 0.905\u20130.95) and 0.915 (95% CI 0.871\u20130.952), respectively. Pooled complication rates of thoracentesis and thoracoscopy were 0.041 (95% CI 0.025\u20130.051) and 0.040 (95% CI 0.029\u20130.052), respectively. Heterogeneity was significant for all meta-analyses. Funnel plots were asymmetric.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Sensitivity of thoracentesis varied significantly per cancer type. Pooled complication rates were low. Awareness of how sensitivity of thoracentesis changes across cancers can improve decision-making when MPE is suspected.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/16000617.0053-2022","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T04:40:11Z","timestamp":1671597611000},"page":"220053","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":46,"title":["Sensitivity and complications of thoracentesis and thoracoscopy: a meta-analysis"],"prefix":"10.1183","volume":"31","author":[{"given":"Gabriela","family":"Martinez-Zayas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Molina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Ost","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"key":"2024102404064829000_31.166.220053.1","first-page":"CD010529","article-title":"Interventions for the management of malignant pleural effusions: a network meta-analysis","volume":"2016","author":"Clive","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2024102404064829000_31.166.220053.2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00349-2018"},{"issue":"Suppl. 10","key":"2024102404064829000_31.166.220053.3","doi-asserted-by":"crossref","first-page":"S1111","DOI":"10.21037\/jtd.2017.07.79","article-title":"Diagnosis and management of malignant pleural effusions: state of the art in 2017","volume":"9","author":"Desai","year":"2017","journal-title":"J Thorac Dis"},{"key":"2024102404064829000_31.166.220053.4","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003698"},{"key":"2024102404064829000_31.166.220053.5","doi-asserted-by":"crossref","first-page":"234","DOI":"10.4143\/crt.2002.34.3.234","article-title":"Cytogenetic study in suspicious cases of malignant pleural effusion","volume":"34","author":"Han","year":"2002","journal-title":"Cancer Res Treat"},{"key":"2024102404064829000_31.166.220053.6","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.136978"},{"key":"2024102404064829000_31.166.220053.7","doi-asserted-by":"publisher","DOI":"10.1378\/chest.67.5.536"},{"key":"2024102404064829000_31.166.220053.8","first-page":"320","article-title":"Diagnostic efficacy of pleural biopsy as compared with that of pleural fluid examination","volume":"4","author":"Nance","year":"1991","journal-title":"Mod Pathol"},{"key":"2024102404064829000_31.166.220053.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)60212-2"},{"key":"2024102404064829000_31.166.220053.10","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1159\/000490732","article-title":"Sensitivity of initial thoracentesis for malignant pleural effusion stratified by tumor type in patients with strong evidence of metastatic disease","volume":"96","author":"Grosu","year":"2018","journal-title":"Respiration"},{"key":"2024102404064829000_31.166.220053.11","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01254-2018"},{"key":"2024102404064829000_31.166.220053.12","doi-asserted-by":"crossref","first-page":"446","DOI":"10.21037\/tlcr.2020.03.28","article-title":"Comparison between closed pleural biopsy and medical thoracoscopy for the diagnosis of undiagnosed exudative pleural effusions: a systematic review and meta-analysis","volume":"9","author":"Wei","year":"2020","journal-title":"Transl Lung Cancer Res"},{"key":"2024102404064829000_31.166.220053.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"2024102404064829000_31.166.220053.14","doi-asserted-by":"publisher","DOI":"10.1059\/0003-4819-155-8-201110180-00009"},{"key":"2024102404064829000_31.166.220053.15","unstructured":"National Heart, Lung, and Blood Institute . 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