To the Editor.—
The recent article by Grogan et al1 concluded that sonography-guided thoracentesis is the method of choice because it has the least complications. However, I am concerned that the authors may have underestimated the impact of interperformer variability because they do not state how many different residents performed procedures in each group and what was their level of training or prior experience with thoracentesis. The radiology residents are likely to have had advantages other than the ability to visualize the effusion. First, it is likely that there are many more medical residents than radiology residents, allowing for more procedures per resident for radiology. Second, radiology residents have already gone through internship and presumably had some prior experience with thoracentesis. On the other hand, procedures are much more likely to be done by the most junior, and least experienced, member of the medical team—the intern. Because the study
Burdge CR. Sonography-Guided Thoracentesis. Arch Intern Med. 1991;151(12):2485–2489. doi:10.1001/archinte.1991.00400120113032
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