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Special Comments by Survey Participants All the special comments written by the survey participants are grouped into several areas of bronchoscopy practice and are listed in Table 11. There were disagreements on whether the ACCP should set guidelines. Summary A mail survey of this type, has several inherent drawbacks. First, answers to sothe of the questions, particularly those pertaining to complication rates, rely on the memory of participants. Second, the wording of certain questions may have imparted different meanings. Third, the format of the questionnaire may have confused some. Fourth, one cannot expect that all questionnaires will be answered fully. Fifth, as indicated by several respondents, several important topics (eg, topical anesthetic agents and mode of their delivery, prophylaxis against infective endocarditis, tracheobronchial stent placement, endobronchial intraluminal radiotherapy) were not included. Many respondents suggested inclusion of these and other questions in future surveys. Nevertheless, in the absence of any survey looking into a large number of bronchoscopy-related practices, mail surveys have the advantage of reflecting nationwide practice rather than results from selected centers, and this report provides some insight into bronchoscopy practices in North America. While the results indicate the present trends in bronchoscopy practices in North America, they do not establish or recommend any standards in bronchoscopy. Table 11—Special Comments by 109 Survey Respondents

ACCP should set guidelines for bronchoscopy	13
Medicare/insurance should pay more for	12
bronchoscopy
Bronchoscopy overused	12
Number of bronchoscopic procedures has no	11
bearing on competence
No deaths	7
It is risky to establish guidelines	7
Switched from nasal to oral bronchoscopy	7
ACCP should organize bronchoscopy workshops	6
Use TTNA instead of TBLB	5
BAL overused in immunocompromised patients	4
BAL in nonimmunocompromised patients	4
should be used only in research
Biplane fluoroscopy needed	3
Brachytherapy better than laser therapy	3
Otherf	15