American Association of Clinical Endocrinology And Associazione Medici Endocrinologi Thyroid Nodule Algorithmic Tool

2021 ◽  
Author(s):  
Jeffrey R. Garber ◽  
Enrico Papini ◽  
Andrea Frasoldati ◽  
Mark A. Lupo ◽  
R. Mack Harrell ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
American Association ◽  
Clinical Endocrinology

American Association of Clinical Endocrinology And Associazione Medici Endocrinologi Thyroid Nodule Algorithmic Tool

2021 ◽  
Vol 21 (11) ◽  
pp. 2104-2115
Author(s):  
Jeffrey R. Garber ◽  
Enrico Papini ◽  
Andrea Frasoldati ◽  
Mark A. Lupo ◽  
R. Mack Harrell ◽  
...  
Keyword(s):  
Decision Making ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Clinical Decision Making ◽  
American Association ◽  
Task Force ◽  
Clinical Endocrinology ◽  
Diagnostic Procedures ◽  
Classification Systems ◽  
Web Based

<P>Objective: The first edition of the American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi Guidelines for the Diagnosis and Management of Thyroid Nodules was published in 2006 and updated in 2010 and 2016. The American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi multidisciplinary thyroid nodules task force was charged with developing a novel interactive electronic algorithmic tool to evaluate thyroid nodules. <P> Methods: The Thyroid Nodule App (termed TNAPP) was based on the updated 2016 clinical practice guideline recommendations while incorporating recent scientific evidence and avoiding unnecessary diagnostic procedures and surgical overtreatment. This manuscript describes the algorithmic tool development, its data requirements, and its basis for decision making. It provides links to the web-based algorithmic tool and a tutorial. <P> Results: TNAPP and TI-RADS were cross-checked on 95 thyroid nodules with histology-proven diagnoses. <P> Conclusion: TNAPP is a novel interactive web-based tool that uses clinical, imaging, cytologic, and molecular marker data to guide clinical decision making to evaluate and manage thyroid nodules. It may be used as a heuristic tool for evaluating and managing patients with thyroid nodules. It can be adapted to create registries for solo practices, large multispecialty delivery systems, regional and national databases, and research consortiums. Prospective studies are underway to validate TNAPP to determine how it compares with other ultrasound-based classification systems and whether it can improve the care of patients with clinically significant thyroid nodules while reducing the substantial burden incurred by those who do not benefit from further evaluation and treatment.</P>

scholarly journals Role of Ultrasonography in Otolaryngology

2016 ◽  
Vol 24 (2) ◽  
pp. 80-87
Author(s):  
Rezaul Karim
Keyword(s):  
Thyroid Nodules ◽  
American Association ◽  
Clinical Endocrinology ◽  
Therapeutic Interventions ◽  
Standard Protocol ◽  
Imaging Tool ◽  
The Masses ◽  
Fair Degree

Ultrasonography (US) is frequently requested by the otolaryngologists in their day to day practice. Though US assessment is sensitive and in many situations, specific investigation for prognosis and management of patients, FNAC and Ultrasonography carries more predictive value. Ultrasonography is very useful for assessment of neck nodes and in combination with CT scan is an excellent imaging tool for follow up of head and neck cancers. Inflammatory neck nodes vary in characteristics from neoplastic nodes and US can classify them with fair degree of predictability. Thyroid nodules should strictly follow standard protocol of management, as most of the masses are benign and unnecessary diagnostic or therapeutic interventions are not required. Kim’s criteria and American Association for Clinical Endocrinology recommendations are sensitive and specific for offering systematic guidance for management of thyroid nodules. US have limited roles in the assessments of sialadenitis, Sialolithiasis and salivary tumors. US is an effective tool in guiding biopsies and aspirations for diagnostic and therapeutic purposes.

scholarly journals Decision Analysis of Discordant Thyroid Nodule Biopsy Guideline Criteria

2008 ◽  
Vol 93 (8) ◽  
pp. 3037-3044 ◽  
Author(s):  
Christopher R. McCartney ◽  
George J. Stukenborg
Keyword(s):  
Decision Analysis ◽  
Thyroid Nodule ◽  
Thyroid Surgery ◽  
Thyroid Nodules ◽  
American Association ◽  
A Priori ◽  
Sensitivity Analyses ◽  
American Thyroid Association ◽  
Diagnostic Approaches ◽  
Expected Values

Abstract Context: Recently published guidelines are discordant regarding diagnostic approaches to small (10–14 mm) thyroid nodules. Objective: The objective of the study was to explore the relative desirability of alternative diagnostic approaches to small thyroid nodules using decision analysis. Design: Four 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 Measures: Measures 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. Results: Expected 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. Conclusions: As 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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