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;
132:622-627. [PMID:
35778811 DOI:
10.1177/00034894221111097]
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Abstract
OBJECTIVE
To determine whether thyroid nodule surveillance compliance is influenced by patient demographics or plan type.
STUDY DESIGN
Retrospective case series from 2010 to 2018.
SETTING
United States Military Health System.
METHODS
There were 481 patients with a thyroid nodule fine-needle aspiration classified as atypia of undetermined significance for whom treatment and follow-up information were available. Demographic information and surveillance plan type were extracted from the medical record and statistical analysis was performed to determine whether these characteristics influenced compliance rates.
RESULTS
A total of 289 nodules were surveilled and 192 diagnostic lobectomies were performed. An initial surveillance plan was documented in 93% (268/289) and 86% (231/268) complied. The most common plans were repeat biopsy in 78% (210/268) or ultrasound in 20% (53/268). A second plan was documented in 88% (204/231) of those who complied with the first. The most common second plans were ultrasound in 87% (178/204) or repeat biopsy in 8% (17/204). Compliance with the second plan was 64% (130/204), significantly lower than with the first (OR 3.6, 95% CI: [2.3, 5.6], P < .0001). Only 45% (130/289) were surveilled twice. Age and gender did not significantly affect compliance rates. Compliance with primary care ultrasound surveillance was 40% (21/52), significantly lower than with a specialist (77% [137/179]; OR 4.8, 95% CI: [2.5, 9.3, P < .0001).
CONCLUSION
Compliance with surveillance of thyroid nodules classified as atypia of undetermined significance was poor in this military cohort. Ultrasound surveillance by a specialist may be more reliable than with primary care.
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