Laryngeal dysplasia and narrow band imaging: Secondary analysis of published data supports the role in patient follow-up

Vinidh Paleri; Rupali Sawant; Hisham Mehanna; Holly Ainsworth; Deborah Stocken

doi:10.1111/coa.13182

Laryngeal dysplasia and narrow band imaging: Secondary analysis of published data supports the role in patient follow-up

Clin Otolaryngol. 2018 Dec;43(6):1439-1442. doi: 10.1111/coa.13182. Epub 2018 Aug 7.

Authors

Vinidh Paleri¹, Rupali Sawant², Hisham Mehanna³, Holly Ainsworth⁴, Deborah Stocken⁵

Affiliations

¹ The Royal Marsden NHS Foundation Trust, London, UK.
² Biostatistics Research Group, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.
³ St. John's Hospital, Livingston, UK.
⁴ Institute of Head and Neck Studies and Education, University of Birmingham, Birmingham, UK.
⁵ Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.

PMID: 29972728
DOI: 10.1111/coa.13182

Abstract

Background: Clinicians have recognised the role of narrow band imaging (NBI) in the management of head and neck cancer in several studies. However, a recent systematic review was unable to pool the data on diagnostic efficacy in this setting owing to the heterogeneity in the published data.

Methods: Secondary analysis of data, utilising Bayes' theorem, from meta-analyses and randomised trials.

Results: In patients with a histological diagnosis of mild dysplasia who show no abnormalities on NBI, the post-test probability of malignancy is estimated to be 2.3%, compared to 10.3% with conventional white light imaging (WLI). For severe dysplasia, similar post-test probabilities after NBI and WLI are estimated to be 8.0% and 29.7%, respectively. Post-test probabilities in this setting indicate the chance of missing malignancy following a negative NBI or WLI in patients who undergo no further intervention. This study also provides a nomogram designed for use in this setting.

Conclusions: This study identifies the evidence base for use of NBI in the follow-up for laryngeal dysplasia.

Keywords: general; outcomes; research; systematic reviews.

Publication types

Meta-Analysis
Review

MeSH terms

Follow-Up Studies
Humans
Laryngeal Diseases / diagnosis*
Larynx / diagnostic imaging*
Narrow Band Imaging / methods*
Reproducibility of Results