Authors' objectives: To identify and evaluate evidence on diagnostic accuracy/ performance, safety, organisational aspects, and economic implication related to transbronchial lung cryobiopsy (TBLC) in patient with ILD.

Authors' results and conclusions: Data on the accuracy and safety of TBLC for the diagnoses of ILD remain limited. Conversely, a substantial body of retrievable evidence suggests that the histopathological and multidisciplinary discussion-based diagnostic yield of TBLC seems promising and superior to forceps biopsy but lower than SLB or VATS-biopsy, with variable frequencies of complications dominated by pneumothorax and moderate-to-severe bleeding or haemorrhage. Above all, good agreement was shown between TBLC and SLB obtained sequentially from the same patients, supporting the clinical utility of TBLC as an alternative to SLB for patients requiring lung tissue for ILD diagnosis. Sampling at least two samples in different sites results in a higher diagnostic yield, although at the expense of more pneumothoraces. Nonetheless, TBLC has the potential to deliver significant cost savings as compared to SLB or VATS.

Authors' recommendations: Given the current available evidence with an acceptable safety profile and potential cost savings, TBLC could be considered either as an alternative or to replace SLB as the first biopsy modality in the evaluation of patients with ILD, provided training and local expertise (clinicians, radiologists, and pathologists) are available.

Authors' methods: A systematic review was conducted. Review protocol and search strategy was developed by the main author and Information Specialist. The following electronic databases were searched through the Ovid interface: Ovid MEDLINE® In-Process & Other Non-Indexed Citations and Ovid MEDLINE® 1946 to 13th November 2020, EBM Reviews - Health Technology Assessment (4th Quarter 2016), EBM Reviews - Cochrane Database of Systematic Review (2005 to 13th November 2020), EBM Reviews - Cochrane Central Register of Controlled Trials (October 2020), EBM Reviews – Database of Abstracts of Review of Effects (1st Quarter 2016), and EBM Reviews - NHS Economic Evaluation Database (1st Quarter 2016). Parallel searches were run in PubMed, US FDA and INAHTA database. No limits were applied to the search. Additional articles were identified from reviewing the references of retrieved articles. The last search was performed on 4th January 2021.

Project Status: Completed

Year Published: 2020

URL for published report: http://www.moh.gov.my/index.php/database_stores/store_view_page/30/368

Requestor: Decision making committee

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Malaysia

Organisation Name: Malaysian Health Technology Assessment

Contact Address: Malaysian Health Technology Assessment Section, Ministry of Health Malaysia, Federal Government Administrative Centre, Level 4, Block E1, Parcel E, 62590 Putrajaya Malaysia Tel: +603 8883 1229

Contact Name: htamalaysia@moh.gov.my

Contact Email: htamalaysia@moh.gov.my

Copyright: Malaysian Health Technology Assessment Section (MaHTAS)