Document Detail

Surgeons overestimate the risk of malignancy in thyroid nodules, evaluation of subjective estimates using a bayesian analysis.
MedLine Citation:
PMID:  22674371     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Thyroid nodules are the most common endocrine condition treated by surgeons. The main purpose of the evaluation of a thyroid nodule is to rule out a carcinoma. Medical decisions concerning thyroid nodules are highly influenced by subjective beliefs.
OBJECTIVE: To assess the subjective probabilities of malignancy that are assigned to the clinical characteristics of a patient with a thyroid nodule in order to determine the degree of influence that these probabilities have on the final clinical suspicion of malignancy compared with objective data.
MATERIAL AND METHODS: A bayesian analysis was designed to predict the risk of malignancy of a thyroid nodule based on the causal relationship between the demographic and clinical risk factors that are detected during the first consultation. A model with demographic and clinical variables using general surgeons as experts was developed.
RESULTS: The highest probability of malignancy (94%) was assigned to the pooled case of a male who was older than 60 years, with dysphonia, dysphagia, accelerated growth rate of the nodule and previous neck radiotherapy and who had a relative with thyroid cancer as well as multiple nodules that were larger than 1 cm and with hard consistency and palpable neck lymph nodes. For low risk cases in which the nodule characteristics are not suggestive of malignancy, the probability of malignancy assigned by clinicians was 33.59%; for high risk cases this was 75.54%.
CONCLUSION: Surgeons make diagnostic decisions based on subjective beliefs that do not necessarily correspond to the objective measures of the characteristics of the nodules.
Edgar Alfonso; Alvaro Sanabria; Mario Castillo
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Biomédica : revista del Instituto Nacional de Salud     Volume:  31     ISSN:  0120-4157     ISO Abbreviation:  Biomedica     Publication Date:    2011 Oct-Dec
Date Detail:
Created Date:  2012-06-07     Completed Date:  2012-10-30     Revised Date:  2013-01-30    
Medline Journal Info:
Nlm Unique ID:  8205605     Medline TA:  Biomedica     Country:  Colombia    
Other Details:
Languages:  eng     Pagination:  590-8     Citation Subset:  IM    
Grupo Sistemas Logísticos, Facultad de Ingeniería, Universidad de La Sabana, Chía, Colombia.
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MeSH Terms
Bayes Theorem
General Surgery*
Middle Aged
Risk Assessment
Thyroid Nodule / pathology*
Comment In:
Biomedica. 2012 Jan-Mar;32(1):158-60   [PMID:  23235798 ]

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