Evidence map›Paper›PMID 27804016›Full record

Observational studyEndocrine2017

Ultrasonography scoring systems can rule out malignancy in cytologically indeterminate thyroid nodules.

Giorgio Grani, Livia Lamartina, Valeria Ascoli, Daniela Bosco, Francesco Nardi, Ferdinando D'Ambrosio, Antonello Rubini, Laura Giacomelli, Marco Biffoni, Sebastiano Filetti and 2 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Endocrine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 7 pooled it
10.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 7 syntheses or guidelines pooled it, 102 citations in OpenAlex.

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  13. Thyroid nodules: diagnosis and management.Nature reviews. Endocrinology · 2024
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  15. Indolent Behavior of Malignant Bethesda III Nodules Compared to Bethesda V/VI Nodules.The Journal of clinical endocrinology and metabolism · 2024
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5 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Giorgio GraniDepartment of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Rome, Italy.
Livia LamartinaDepartment of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Rome, Italy.
Valeria AscoliDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy.
Daniela BoscoDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy.
Francesco NardiDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy.
Ferdinando D'AmbrosioDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy.
Antonello RubiniDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy.
Laura GiacomelliDepartment of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
Marco BiffoniDepartment of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
Sebastiano FilettiDepartment of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Rome, Italy.
Cosimo DuranteDepartment of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Rome, Italy. cosimo.durante@uniroma1.it.ORCID http://orcid.org/0000-0002-1791-5915
Vito CantisaniDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy.
Sapienza University of Rome · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the accuracy and reproducibility of ultrasonography classification systems in characterizing cytologically indeterminate thyroid nodules.

methodsWe retrospectively identified 49 nodules that had been surgically resected owing to features classified as indeterminate according to 2010 Italian Consensus on Thyroid Cytology criteria. Three experienced sonographers independently reviewed original sonographic images of each nodule and classified it using the 2015 American Thyroid Association (ATA) guidelines and the Thyroid Imaging Reporting and Data System (TI-RADS) classification proposed by Korean radiologists; later, images were reviewed jointly to obtain consensus classifications of each nodule. Original cytology slides were similarly reviewed by three experienced cytopathologists, who reclassified the nodule (independently, then jointly) according to revised Italian Consensus on Thyroid Cytology (ICTC-2014) criteria. Consensus ICTC-2014, ATA, and TI-RADS classifications were analyzed against surgical histology reports to estimate each system's sensitivity, specificity, positive and negative predictive values.

resultsOf the 49 indeterminate nodules examined, 30 (61.2 %) were histologically benign. Consensus ICTC-2014 classification correctly classified malignant nodules with positive predictive value of 50 % and negative predictive value of 90 %. Sonographic classification of nodules as intermediate to high suspicion by ATA or TI-RADS category 4c displayed positive predictive value of 63 and 71 %, respectively; positive predictive values dropped to 44 and 42 % when lower positivity thresholds were used (ATA low suspicion, TI-RADS category 4a). Negative predictive values for ATA and TI-RADS were 91 and 74 %, respectively, with higher positivity thresholds and 100 % for both with lower thresholds. All systems displayed appreciable inter-observer variability (Krippendorff alphas: ATA 0.36, TIRADS 0.42, ICTC-2014 0.74).

conclusionsWith stringent negativity cut-offs, American Thyroid Association and Thyroid Imaging Reporting and Data System assessment of cytologically indeterminate thyroid nodules allows high-confidence exclusion of malignancy.

Indexed as

AdultAgedDiagnosis, DifferentialFemaleHumansMaleMiddle AgedPredictive Value of TestsReproducibility of ResultsRetrospective StudiesSensitivity and SpecificityThyroid NeoplasmsThyroid NoduleTomography, X-Ray ComputedUltrasonographyIndeterminateThyroid noduleTIRADSUltrasonography

Identifiers

PMID27804016
OpenAlexW2540061378

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.