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In Reply Drs Madan and Guleria question the study design of the trial and ask why conventional TBNA was not included. In designing the GRANULOMA trial, we chose to compare endosonography (EBUS-guided TBNA) with the existing standard biopsy technique. The statement on sarcoidosis from the American Thoracic Society, European Respiratory Society, and the World Association for Sarcoidosis and Other Granulomatous Disorders recommends performing TBLB, not conventional TBNA, when tissue sampling is indicated.1
Annema JT. Comparison of Methods to Diagnose Sarcoidosis—Reply. JAMA. 2013;310(15):1625-1626. doi:10.1001/jama.2013.277322