Supplementary Material for: Bone Marrow Aspiration: A Randomized Controlled Trial Assessing the Quality of Bone Marrow Specimens Using Slow and Rapid Aspiration Techniques and Evaluating Pain Intensity

Background/Aims: Bone marrow aspiration (BMA) is an essential procedure in the examination of hematological disorders, but there is limited evidence as to whether the aspiration rate affects specimen quality. We aimed to assess the specimen quality and pain intensity using slow (S-technique) or rapid (R-technique) aspiration. Methods: This was a single-center, prospective, randomized patient- and assessor-blinded study of 482 patients scheduled for BMA. Specimen quality was evaluated by grading bone marrow (BM) cellularity and counting the number of marrow particles. Pain was assessed using a visual analog scale (VAS). Results: We found a significant difference between the 2 groups with regard to the quality of specimens. For cellularity, the odds ratio (OR) for having a poor quality aspirate using the S-technique versus the R-technique was 3.05 [confidence interval (CI) 1.79-5.31]. For BM particles, the quality of specimens with the S-technique proved to be poor compared with the R-technique (OR 2.52; CI 1.51-4.28). We found a statistically significant difference of 1 VAS point (p < 0.001) of the median pain intensity in favor of the S-technique. Conclusion: Even though the pain intensity is significantly higher with the R-technique, the median difference is relatively small. We propose that the R-technique is preferable to the S-technique due to better specimen quality.

背景/目的：骨髓穿刺术（BMA）是血液系统疾病检查中的关键程序，然而关于穿刺率是否影响标本质量，现有证据有限。本研究旨在评估采用慢速（S-技术）或快速（R-技术）穿刺的标本质量及疼痛强度。方法：这是一项单中心、前瞻性、随机、患者和评估者盲法的482例骨髓穿刺术患者的临床研究。标本质量通过评估骨髓（BM）细胞学分级和计数骨髓颗粒数量进行评定。疼痛程度采用视觉模拟评分法（VAS）进行评估。结果：我们发现两组在标本质量方面存在显著差异。就细胞学而言，使用S-技术与R-技术相比，获得低质量穿刺标本的比值比（OR）为3.05[可信区间（CI）1.79-5.31]。对于骨髓颗粒，S-技术标本的质量与R-技术相比，证实为较差（OR 2.52；CI 1.51-4.28）。我们发现S-技术的中位疼痛强度与R-技术相比具有统计学意义上的显著差异（p < 0.001）。结论：尽管R-技术的疼痛强度显著较高，但中位差异相对较小。鉴于标本质量更佳，我们建议R-技术优于S-技术。