SAN ANTONIO ― Is thyroid nodule surveillance compliance affected by patient demographics or plan type? That was the question addressed in the recent retrospective case series from 2010 to 2018.
Results were published in the Annals of Otology, Rhinology & Laryngology.1
The research was conducted by the United States Military Health System, including Brooke Army Medical Center in San Antonio, the Walter Reed National Military Medical Center in Bethesda, MD, and the San Antonio Uniformed Services Health Education Consortium.
The focus was on 481 patients with a thyroid nodule fine-needle aspiration classified as atypia of undetermined significance, for which treatment and follow-up information were available. The study team extracted demographic information and surveillance plan type from the medical record, while statistical analysis was performed to determine whether these characteristics influenced compliance rates.
Overall, 289 nodules were surveilled, and 192 diagnostic lobectomies were performed. Results indicated that an initial surveillance plan was documented in 93% (268/289) and 86% (231/268) complied.
The authors pointed out that the most common plans were repeat biopsy in 78% (210/268) or ultrasound in 20% (53/268).
In 88% of those who complied with the first, a second plan was documented. It most commonly was ultrasound in 87% or repeat biopsy in 8%. The study found that compliance with the second plan was 64% (130/204), which was significantly lower than with the first (OR 3.6, 95% CI: [2.3, 5.6], P < .0001).
In fact, the researchers pointed out that only 45% were surveilled twice. Yet, the study determined that age and gender did not significantly affect compliance rates.
The researchers also advised that compliance with primary care ultrasound surveillance was 40% (21/52), much lower than with a specialist (77% [137/179]; OR 4.8, 95% CI: [2.5, 9.3, P < .0001]).
“Compliance with surveillance of thyroid nodules classified as atypia of undetermined significance was poor in this military cohort,” the authors concluded. “Ultrasound surveillance by a specialist may be more reliable than with primary care.”
- Walters BK, Garrett SL, Aden JK, Newberry TR, Mckinlay AJ. Patient Compliance With Surveillance of Thyroid Nodules Classified as Atypia of Undetermined Significance. Ann Otol Rhinol Laryngol. 2022 Jul 1:34894221111097. doi: 10.1177/00034894221111097. Epub ahead of print. PMID: 35778811.
