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Is It Always Better to Get Faster Results in Temporal Artery Biopsies?

Is It Always Better to Get Faster Results in Temporal Artery Biopsies? Is It Always Better to Get Faster Results in Temporal Artery Biopsies? Invited Commentary Invited Commentary Patricia Chévez-Barrios, MD Diagnosis and treatment of giant cell arteritis (GCA) have narios. Cohen et al demonstrate that the frozen section ap- evolved throughout the years. Before the 1990s, the diagno- proach to the TAB, in their hands, has 83.2% sensitivity and sis relied entirely on temporal artery biopsy (TAB)–proven 99.4% specificity for detecting vascular inflammation consis- disease to start the eyesight-saving steroid treatment. Patholo- tent with active GCA with an overall positivity of 15% of all gists used to do frozen sec- the patients studied. They also show, as an important result tions to rapidly render a diag- applying to everyone working with patients suspected for Related article nosis that would inform the GCA, that the discordance rate of bilateral TABs was 5% to decision of whether or not to have the patient start cortico- 5.5%. This is on the low end of what was previously pub- steroid treatment. This sounds like an ideal practice for lished (3%-40%) and supports the relative low need for bilat- patient care, so why have we stopped favoring this approach? eral synchronous TAB for the diagnosis http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Ophthalmology American Medical Association

Is It Always Better to Get Faster Results in Temporal Artery Biopsies?

JAMA Ophthalmology , Volume 139 (4) – Apr 18, 2021

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Publisher
American Medical Association
Copyright
Copyright 2021 American Medical Association. All Rights Reserved.
ISSN
2168-6165
eISSN
2168-6173
DOI
10.1001/jamaophthalmol.2020.6895
Publisher site
See Article on Publisher Site

Abstract

Is It Always Better to Get Faster Results in Temporal Artery Biopsies? Invited Commentary Invited Commentary Patricia Chévez-Barrios, MD Diagnosis and treatment of giant cell arteritis (GCA) have narios. Cohen et al demonstrate that the frozen section ap- evolved throughout the years. Before the 1990s, the diagno- proach to the TAB, in their hands, has 83.2% sensitivity and sis relied entirely on temporal artery biopsy (TAB)–proven 99.4% specificity for detecting vascular inflammation consis- disease to start the eyesight-saving steroid treatment. Patholo- tent with active GCA with an overall positivity of 15% of all gists used to do frozen sec- the patients studied. They also show, as an important result tions to rapidly render a diag- applying to everyone working with patients suspected for Related article nosis that would inform the GCA, that the discordance rate of bilateral TABs was 5% to decision of whether or not to have the patient start cortico- 5.5%. This is on the low end of what was previously pub- steroid treatment. This sounds like an ideal practice for lished (3%-40%) and supports the relative low need for bilat- patient care, so why have we stopped favoring this approach? eral synchronous TAB for the diagnosis

Journal

JAMA OphthalmologyAmerican Medical Association

Published: Apr 18, 2021

References

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