ArticleThe Journal of clinical endocrinology and metabolism2008
Decision analysis of discordant thyroid nodule biopsy guideline criteria.
Article in The Journal of clinical endocrinology and metabolism, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 24 citations in OpenAlex.
- Critical Assessment Is Missing.Deutsches Arzteblatt international · 2017Article
- Thyroid nodule update on diagnosis and management.Clinical diabetes and endocrinology · 2016Review
- Comb-push ultrasound shear elastography (CUSE) for evaluation of thyroid nodules: preliminary in vivo results.IEEE transactions on medical imaging · 2015Article
- RETRACTED ARTICLE: Thyroid nodules update in diagnosis and management.Clinical diabetes and endocrinology · 2015Article
- Proposed algorithm for management of patients with thyroid nodules/focal lesions, based on ultrasound (US) and fine-needle aspiration biopsy (FNAB); our own experience.Thyroid research · 2013Article
- Ultrasound guided fine-needle aspiration biopsy of thyroid nodules: Guidelines and recommendations vs clinical practice; a 12-month study of 89 patients.Journal of ultrasound · 2012Article
- Endocrine Society of India management guidelines for patients with thyroid nodules: A position statement.Indian journal of endocrinology and metabolism · 2011Article
- Thyroid nodules and evaluation of thyroid cancer risk.Australasian journal of ultrasound in medicine · 2010Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
contextRecently published guidelines are discordant regarding diagnostic approaches to small (10-14 mm) thyroid nodules.
objectiveThe objective of the study was to explore the relative desirability of alternative diagnostic approaches to small thyroid nodules using decision analysis.
designFour diagnostic approaches to a 10- to 14-mm thyroid nodule are modeled: 1) observation only, consistent with American Thyroid Association guidelines; 2) routine fine-needle aspiration biopsy (FNAB), an approach traditionally chosen by many endocrinologists and consistent with American Thyroid Association guidelines; 3) FNAB only when microcalcifications are present, as recommended by Society of Radiologists in Ultrasound guidelines; and 4) FNAB only when the nodule is hypoechoic and has at least one other ultrasonographic risk factor, as endorsed by American Association of Clinical Endocrinologists guidelines.
main outcome measuresMeasures included expected values; a priori likelihoods of prespecified outcomes; and two-way sensitivity analyses based on the utility of observation only in the setting of thyroid cancer and thyroid surgery for benign, asymptomatic thyroid disease.
resultsExpected values (EVs) were similar among decision alternatives modeling Society of Radiologists in Ultrasound guidelines, American Association of Clinical Endocrinologists guidelines, and routine observation (EVs from 0.912 to 0.927). Routine FNAB had the lowest EV (0.757-0.861), primarily related to a high a priori likelihood of having surgery for a benign nodule.
conclusionsAs a general approach to 10- to 14-mm thyroid nodules, routine FNAB appears to be the least desirable. This analysis offers additional data that physicians can use when choosing diagnostic approaches to small thyroid nodules based on perceived risks of delayed cancer diagnosis and unnecessary thyroid surgery.
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