Management of nondiagnostic thyroid fine-needle aspiration biopsy: Survey of endocrinologists

Israel B. Orija, Amir Hamrahian, S. Sethu K. Reddy

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the approach of endocrinologists in the setting of nondiagnostic thyroid fine-needle aspiration (FNA) biopsies. Methods: In 2002, we surveyed physicians attending the national annual meetings of the American Association of Clinical Endocrinologists and the Endocrine Society of North America, using a 13-item questionnaire. The responses were tallied and analyzed. Results: Of the 143 respondents, 139 were endocrinologists, with a male:female ratio of 2.5:1. Most respondents were involved in a medical practice in North America, but Europe, Asia, New Zealand, and Australia were also represented. Of those performing thyroid FNA biopsy, 31% used thyroid ultrasound guidance. Among the survey respondents, 16%, 49%, 20%, and 15% performed less than 2, 2 to 5, 6 to 10, and more than 10 thyroid FNA biopsies per month, respectively. Among the respondents, 13.5%, 44%, 28.5%, 10%, and 4% had nondiagnostic rates of less than 5%, 5 to 10%, 11 to 20%, 21 to 30%, and more than 30%, respectively. The approach of the respondents to an initially nondiagnostic FNA was repeated FNA biopsy in 87%, observation in 7%, levothyroxine suppression in 4%, and thyroid scintigraphy in 2%. Respondents believed that the most cost-effective approach in a patient with nondiagnostic FNA was repeated biopsy (82%), monitoring the size of the thyroid nodule (17%), and surgical referral (<1%). No one was willing to repeat the thyroid biopsy more than three times. Conclusion: On the basis of findings in our survey, most endocrinologists repeat thyroid FNA at least once when confronted with a nondiagnostic result. No published studies have demonstrated the cost-effectiveness of this approach versus proceeding to surgical intervention or observation. We hope that this survey will encourage further studies on this issue.

Original languageEnglish (US)
Pages (from-to)317-323
Number of pages7
JournalEndocrine Practice
Volume10
Issue number4
DOIs
StatePublished - Jan 1 2004
Externally publishedYes

Fingerprint

Fine Needle Biopsy
Thyroid Gland
North America
Observation
Endocrinologists
Surveys and Questionnaires
Biopsy
Thyroid Nodule
Thyroxine
New Zealand
Radionuclide Imaging
Cost-Benefit Analysis
Referral and Consultation
Physicians
Costs and Cost Analysis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Management of nondiagnostic thyroid fine-needle aspiration biopsy : Survey of endocrinologists. / Orija, Israel B.; Hamrahian, Amir; Reddy, S. Sethu K.

In: Endocrine Practice, Vol. 10, No. 4, 01.01.2004, p. 317-323.

Research output: Contribution to journalArticle

@article{89d4670a7071440786343dc1c899fa61,
title = "Management of nondiagnostic thyroid fine-needle aspiration biopsy: Survey of endocrinologists",
abstract = "Objective: To evaluate the approach of endocrinologists in the setting of nondiagnostic thyroid fine-needle aspiration (FNA) biopsies. Methods: In 2002, we surveyed physicians attending the national annual meetings of the American Association of Clinical Endocrinologists and the Endocrine Society of North America, using a 13-item questionnaire. The responses were tallied and analyzed. Results: Of the 143 respondents, 139 were endocrinologists, with a male:female ratio of 2.5:1. Most respondents were involved in a medical practice in North America, but Europe, Asia, New Zealand, and Australia were also represented. Of those performing thyroid FNA biopsy, 31{\%} used thyroid ultrasound guidance. Among the survey respondents, 16{\%}, 49{\%}, 20{\%}, and 15{\%} performed less than 2, 2 to 5, 6 to 10, and more than 10 thyroid FNA biopsies per month, respectively. Among the respondents, 13.5{\%}, 44{\%}, 28.5{\%}, 10{\%}, and 4{\%} had nondiagnostic rates of less than 5{\%}, 5 to 10{\%}, 11 to 20{\%}, 21 to 30{\%}, and more than 30{\%}, respectively. The approach of the respondents to an initially nondiagnostic FNA was repeated FNA biopsy in 87{\%}, observation in 7{\%}, levothyroxine suppression in 4{\%}, and thyroid scintigraphy in 2{\%}. Respondents believed that the most cost-effective approach in a patient with nondiagnostic FNA was repeated biopsy (82{\%}), monitoring the size of the thyroid nodule (17{\%}), and surgical referral (<1{\%}). No one was willing to repeat the thyroid biopsy more than three times. Conclusion: On the basis of findings in our survey, most endocrinologists repeat thyroid FNA at least once when confronted with a nondiagnostic result. No published studies have demonstrated the cost-effectiveness of this approach versus proceeding to surgical intervention or observation. We hope that this survey will encourage further studies on this issue.",
author = "Orija, {Israel B.} and Amir Hamrahian and Reddy, {S. Sethu K.}",
year = "2004",
month = "1",
day = "1",
doi = "10.4158/EP.10.4.317",
language = "English (US)",
volume = "10",
pages = "317--323",
journal = "Endocrine Practice",
issn = "1530-891X",
publisher = "American Association of Clinical Endocrinology",
number = "4",

}

TY - JOUR

T1 - Management of nondiagnostic thyroid fine-needle aspiration biopsy

T2 - Survey of endocrinologists

AU - Orija, Israel B.

AU - Hamrahian, Amir

AU - Reddy, S. Sethu K.

PY - 2004/1/1

Y1 - 2004/1/1

N2 - Objective: To evaluate the approach of endocrinologists in the setting of nondiagnostic thyroid fine-needle aspiration (FNA) biopsies. Methods: In 2002, we surveyed physicians attending the national annual meetings of the American Association of Clinical Endocrinologists and the Endocrine Society of North America, using a 13-item questionnaire. The responses were tallied and analyzed. Results: Of the 143 respondents, 139 were endocrinologists, with a male:female ratio of 2.5:1. Most respondents were involved in a medical practice in North America, but Europe, Asia, New Zealand, and Australia were also represented. Of those performing thyroid FNA biopsy, 31% used thyroid ultrasound guidance. Among the survey respondents, 16%, 49%, 20%, and 15% performed less than 2, 2 to 5, 6 to 10, and more than 10 thyroid FNA biopsies per month, respectively. Among the respondents, 13.5%, 44%, 28.5%, 10%, and 4% had nondiagnostic rates of less than 5%, 5 to 10%, 11 to 20%, 21 to 30%, and more than 30%, respectively. The approach of the respondents to an initially nondiagnostic FNA was repeated FNA biopsy in 87%, observation in 7%, levothyroxine suppression in 4%, and thyroid scintigraphy in 2%. Respondents believed that the most cost-effective approach in a patient with nondiagnostic FNA was repeated biopsy (82%), monitoring the size of the thyroid nodule (17%), and surgical referral (<1%). No one was willing to repeat the thyroid biopsy more than three times. Conclusion: On the basis of findings in our survey, most endocrinologists repeat thyroid FNA at least once when confronted with a nondiagnostic result. No published studies have demonstrated the cost-effectiveness of this approach versus proceeding to surgical intervention or observation. We hope that this survey will encourage further studies on this issue.

AB - Objective: To evaluate the approach of endocrinologists in the setting of nondiagnostic thyroid fine-needle aspiration (FNA) biopsies. Methods: In 2002, we surveyed physicians attending the national annual meetings of the American Association of Clinical Endocrinologists and the Endocrine Society of North America, using a 13-item questionnaire. The responses were tallied and analyzed. Results: Of the 143 respondents, 139 were endocrinologists, with a male:female ratio of 2.5:1. Most respondents were involved in a medical practice in North America, but Europe, Asia, New Zealand, and Australia were also represented. Of those performing thyroid FNA biopsy, 31% used thyroid ultrasound guidance. Among the survey respondents, 16%, 49%, 20%, and 15% performed less than 2, 2 to 5, 6 to 10, and more than 10 thyroid FNA biopsies per month, respectively. Among the respondents, 13.5%, 44%, 28.5%, 10%, and 4% had nondiagnostic rates of less than 5%, 5 to 10%, 11 to 20%, 21 to 30%, and more than 30%, respectively. The approach of the respondents to an initially nondiagnostic FNA was repeated FNA biopsy in 87%, observation in 7%, levothyroxine suppression in 4%, and thyroid scintigraphy in 2%. Respondents believed that the most cost-effective approach in a patient with nondiagnostic FNA was repeated biopsy (82%), monitoring the size of the thyroid nodule (17%), and surgical referral (<1%). No one was willing to repeat the thyroid biopsy more than three times. Conclusion: On the basis of findings in our survey, most endocrinologists repeat thyroid FNA at least once when confronted with a nondiagnostic result. No published studies have demonstrated the cost-effectiveness of this approach versus proceeding to surgical intervention or observation. We hope that this survey will encourage further studies on this issue.

UR - http://www.scopus.com/inward/record.url?scp=9644271588&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=9644271588&partnerID=8YFLogxK

U2 - 10.4158/EP.10.4.317

DO - 10.4158/EP.10.4.317

M3 - Article

C2 - 15760774

AN - SCOPUS:9644271588

VL - 10

SP - 317

EP - 323

JO - Endocrine Practice

JF - Endocrine Practice

SN - 1530-891X

IS - 4

ER -