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Sonography-Guided Thoracentesis-Reply

Donna Roy Grogan, MD; Richard S. Irwin, MD
Arch Intern Med. 1991;151(12):2489. doi:10.1001/archinte.1991.00400120113033.
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In Reply. —  Burdge raises the issue of whether our study's1 results were actually due to "interperformer variability" and not only to differences in technique. Because our study was designed to determine the differences in complication rates between three different methods of performing thoracentesis, we cannot specifically comment on the effect of interperformer variability. The house officer group performing the ultrasound method was different from the group performing the needle-only and the needle-catheter techniques (radiology house officers vs medicine house officers). Because we could not completely control for level of expertise of each house officer, we set a minimum level of competency that each house officer in either group had to demonstrate.Burdge also questions if the method used in establishing competency is sufficient. It is difficult to answer this question because there have been no studies that have determined the number of observed thoracenteses a physician must perform


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