Systematic review of clinical practice guidelines in the diagnosis and management of thyroid nodules and cancer

Tsai Wei Huang, Jun Hung Lai, Mei Yi Wu, Shiah Lian Chen, Chih Hsiung Wu, Ka Wai Tam

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background: Given the uncertainties regarding thyroid nodule assessment and management, physicians require systematically and transparently developed recommendations. This systematic review assesses the quality and consistency of the recommendations of international clinical practice guidelines (CPGs) for the diagnosis and management of thyroid nodules and cancer to assist physicians in making appropriate recommendations.Methods: The CPGs on the management of thyroid nodules and cancer published before June 2013 were retrieved. All the reviewed guidelines were in English. Four reviewers independently assessed the rigor of guideline development by using the Appraisal of Guidelines Research and Evaluation II (AGREE-II) instrument, and their reported evidence was evaluated.Results: Ten eligible guidelines were included: nine had been developed by professional organizations, and the remaining guideline was endorsed by an independent regional body. Three guidelines achieved a score of greater than 50% in all six AGREE-II domains. Guidelines scored highest on the measurement of 'scope and purpose' (≥61.1% for eight CPGs) and lowest on the measurement of 'applicability' (≤38.5% for five CPGs). The overall quality ranged from 3.0 to 6.25 on a seven-point scale on the AGREE-II tool. Most CPG recommendations on the management of thyroid cancer were relatively consistent. Guidelines varied regarding the indication of fine-needle aspiration for thyroid nodules, as well as in their suggestions for postoperative radioiodine ablation.Conclusions: Our analysis showed that the current CPGs varied in methodological quality. More effort is needed to improve the quality of recommendations on the diagnosis and management of thyroid nodules and cancer.

Original languageEnglish
Article number191
JournalBMC Medicine
Volume11
Issue number1
DOIs
Publication statusPublished - Aug 29 2013

Fingerprint

Thyroid Nodule
Thyroid Neoplasms
Practice Guidelines
Guidelines
Physicians
Practice Management
Fine Needle Biopsy
Uncertainty

Keywords

  • Clinical practice guidelines
  • Systematic review
  • Thyroid cancer
  • Thyroid nodule

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Systematic review of clinical practice guidelines in the diagnosis and management of thyroid nodules and cancer. / Huang, Tsai Wei; Lai, Jun Hung; Wu, Mei Yi; Chen, Shiah Lian; Wu, Chih Hsiung; Tam, Ka Wai.

In: BMC Medicine, Vol. 11, No. 1, 191, 29.08.2013.

Research output: Contribution to journalArticle

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