Evidence map›Paper›PMID 29147894›Full record

ArticleWorld journal of surgery2018

Chest X-ray Prior to Thyroidectomy: Is It Really Needed?

Alexandra Mikhael, Rushad Patell, Michael Tabet, James Bena, Eren Berber, Christian Nasr

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Article in World journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 35% 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

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
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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

6 authors at 3 institutions in 1 country.

Alexandra MikhaelInternal Medicine Department, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. mikhaea@ccf.org.
Rushad PatellInternal Medicine Department, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Michael TabetUniversity of Vermont, Burlington, VT, 05405, USA.
James BenaQuantitative Health Sciences Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Eren BerberEndocrinology and Metabolism Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Christian NasrEndocrinology and Metabolism Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Cleveland Clinic · USCleveland Foundation · USUniversity of Vermont · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChest X-ray (CXR) prior to thyroid surgery continues to be routinely obtained at some institutions despite the lack of evidence for its utility. This study aimed to determine the utility of preoperative CXR in patients undergoing thyroidectomy at a single institution.

methodsIn total, 594 thyroidectomy patients were included in the study. Demographics, CXR findings, anesthesia records and pathologic data were assessed. We investigated whether difficult intubation or cancer stage correlated with the presence of CXR abnormalities.

resultsOf the total cohort, 83% had a preoperative CXR and 67% had cancer on surgical pathology. In total, 56% had at least one CXR abnormality, the most frequent being skeletal abnormalities (25%), followed by tracheal deviation (16%). Of 78 patients (15.8%) with tracheal deviation on CXR, only 5% had a difficult intubation. Tracheal deviation was more commonly seen in non-cancer cases compared to cancer cases (27 vs. 12%, p < 0.001). CXR impacted management in 4%. Among patients with cancer, a higher T-stage (>2) was associated with higher rate of tracheal deviation compared to T1 (17 vs. 8%, p < 0.001). While patients with non-metastatic cancer (n = 277) compared to metastatic cancer patients had a higher proportion of any abnormality on CXR (57 vs. 44%, p = 0.045), there was no significant difference for tracheal deviation, skeletal abnormalities or lung nodules. Of patients with nodules on CXR (n = 29), only 14% were found to have metastatic disease.

conclusionThe utility of preoperative CXR in patients undergoing thyroidectomy is very limited. In the climate of value-based care, routine use of this modality may be redundant and should only be ordered if clinically indicated.

Indexed as

Preoperative CareRadiography, ThoracicThyroidectomyUnnecessary ProceduresCardiomegalyHumansRetrospective StudiesThyroid NeoplasmsThyroid NoduleTrachea

Identifiers

PMID29147894
OpenAlexW2769028887

What OpenQuestion holds

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Registered trials

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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.