TY - JOUR
T1 - Healthcare impact of introduction of thyroid ultrasound in a thyroid nodule pathology unit
AU - Castells, Ignasi
AU - Pardo, Núria
AU - Videla, Sebastián
AU - Giménez, Gabriel
AU - Llargues, Esteve
AU - Simó, Olga
AU - Recasens, María Asunción
AU - Guirao, Xavier
AU - Mira, Xavier
AU - Serrano, àngel
AU - Sanmartí, Anna
PY - 2013/2/1
Y1 - 2013/2/1
N2 - Introduction: Worldwide incidence of thyroid cancer has increased in recent decades. Objective: To provide evidence of the diagnostic and care efficiency of a monographic thyroid nodule clinic integrating clinical examination, ultrasound examination, and cytology with on site evaluation. Patients and methods: Patients attending the monographic thyroid nodule clinic from January 2004 to June 2010. Two periods may be distinguished based on availability of ultrasound equipment at the time of the visit: a first period (P1: 01/2004-09/2007) where no ultrasound equipment was available at the clinic and FNA by palpation was performed, and a second period (P2: 10/2007-06/2010) where this equipment was available and ultrasound-guided FNA was performed. Results: A total of 1036 patients [P1: 537 (52%), P2: 499 (48%)] were seen and enrolled.Diagnostic efficiency (P1 vs P2): 143 vs 181 patients were seen annually, p<0.001; FNA number/nodule: 1.68 vs 1.17, p<0.001; percent FNAs with inadequate material: 26% vs 5.3%, p<0.001; mean (SD) nodule size: 23.6 (12.4) vs 21.7 (11.7) mm, p 0.040; proportion of nodules examined less than 10. mm in size: 9.9% vs 13.7%, p 0.030.Care efficiency: mean time (range) from the first visit to surgery indication: 332 (0-2177) vs 108 (0-596) days, p<0.001; proportion of patients referred for surgery due to suspect cytology/other reasons: 1.06 vs 2.21, p<0.001; and operated benign neoplasm/pathology: 0.47 vs 0.93, p=0.002. Conclusion: A monographic thyroid nodule clinic integrating clinical examination, ultrasound, and cytology evaluated on site increases diagnostic and care efficiency in patients with thyroid nodules. © 2012 SEEN.
AB - Introduction: Worldwide incidence of thyroid cancer has increased in recent decades. Objective: To provide evidence of the diagnostic and care efficiency of a monographic thyroid nodule clinic integrating clinical examination, ultrasound examination, and cytology with on site evaluation. Patients and methods: Patients attending the monographic thyroid nodule clinic from January 2004 to June 2010. Two periods may be distinguished based on availability of ultrasound equipment at the time of the visit: a first period (P1: 01/2004-09/2007) where no ultrasound equipment was available at the clinic and FNA by palpation was performed, and a second period (P2: 10/2007-06/2010) where this equipment was available and ultrasound-guided FNA was performed. Results: A total of 1036 patients [P1: 537 (52%), P2: 499 (48%)] were seen and enrolled.Diagnostic efficiency (P1 vs P2): 143 vs 181 patients were seen annually, p<0.001; FNA number/nodule: 1.68 vs 1.17, p<0.001; percent FNAs with inadequate material: 26% vs 5.3%, p<0.001; mean (SD) nodule size: 23.6 (12.4) vs 21.7 (11.7) mm, p 0.040; proportion of nodules examined less than 10. mm in size: 9.9% vs 13.7%, p 0.030.Care efficiency: mean time (range) from the first visit to surgery indication: 332 (0-2177) vs 108 (0-596) days, p<0.001; proportion of patients referred for surgery due to suspect cytology/other reasons: 1.06 vs 2.21, p<0.001; and operated benign neoplasm/pathology: 0.47 vs 0.93, p=0.002. Conclusion: A monographic thyroid nodule clinic integrating clinical examination, ultrasound, and cytology evaluated on site increases diagnostic and care efficiency in patients with thyroid nodules. © 2012 SEEN.
KW - Care efficiency
KW - Monographic clinic
KW - Thyroid cancer
KW - Thyroid nodule
U2 - 10.1016/j.endonu.2012.05.005
DO - 10.1016/j.endonu.2012.05.005
M3 - Article
VL - 60
SP - 53
EP - 59
IS - 2
ER -