Jeffrey R Garber1, Enrico Papini2, Andrea Frasoldati3, Mark A Lupo4, R Mack Harrell5, Sareh Parangi6, Vivek Patkar7, Zubair W Baloch8, Rachel Pessah-Pollack9, Laszlo Hegedus10, Anna Crescenzi11, Carrie C Lubitz12, Ralf Paschke13, Gregory W Randolph14, Rinaldo Guglielmi2, Celestino P Lombardi15, Hossein Gharib16. 1. Endocrine Division, Harvard Vanguard Medical Associates, Boston, Massachusetts; Division of Endocrinology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: jgarber@bidmc.harvard.edu. 2. Endocrinology and Metabolism Department, Regina Apostolorum Hospital, Albano, Rome, Italy. 3. Metabolism and Nutrition Department, Santa Maria Nuova Hospital Scientific Institute for Research, Hospitalization and Healthcare, Reggio Emilia, Italy. 4. Thyroid & Endocrine Center of Florida, Sarasota, Florida; Florida State University College of Medicine, Sarasota, Florida. 5. Memorial Center for Integrative Endocrine Surgery, Hollywood, Florida. 6. Harvard Medical School, Boston, Massachusetts; Newton-Wellesley Hospital, Newton, Massachusetts; Department of Endocrine Surgery, Massachusetts General Hospital, Boston, Massachusetts. 7. Deontics Ltd, London, England. 8. Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania. 9. Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, New York. 10. University of Southern Denmark, Odense, Denmark; Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark. 11. Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy. 12. Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. 13. Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 14. Harvard Medical School, Boston, Massachusetts; Thyroid/Parathyroid Endocrine Surgical Division, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Endocrine Surgical Service, Massachusetts General Hospital, Boston, Massachusetts. 15. Endocrine Surgery Department, Policlinico Agostino Gemelli, Catholic University, Rome, Italy. 16. Mayo Clinic College of Medicine, Rochester, Minnesota.
Abstract
OBJECTIVE: The first edition of the American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi Guidelines for the Diagnosis and Management of Thyroid Nodules was published in 2006 and updated in 2010 and 2016. The American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi multidisciplinary thyroid nodules task force was charged with developing a novel interactive electronic algorithmic tool to evaluate thyroid nodules. METHODS: The Thyroid Nodule App (termed TNAPP) was based on the updated 2016 clinical practice guideline recommendations while incorporating recent scientific evidence and avoiding unnecessary diagnostic procedures and surgical overtreatment. This manuscript describes the algorithmic tool development, its data requirements, and its basis for decision making. It provides links to the web-based algorithmic tool and a tutorial. RESULTS: TNAPP and TI-RADS were cross-checked on 95 thyroid nodules with histology-proven diagnoses. CONCLUSION: TNAPP is a novel interactive web-based tool that uses clinical, imaging, cytologic, and molecular marker data to guide clinical decision making to evaluate and manage thyroid nodules. It may be used as a heuristic tool for evaluating and managing patients with thyroid nodules. It can be adapted to create registries for solo practices, large multispecialty delivery systems, regional and national databases, and research consortiums. Prospective studies are underway to validate TNAPP to determine how it compares with other ultrasound-based classification systems and whether it can improve the care of patients with clinically significant thyroid nodules while reducing the substantial burden incurred by those who do not benefit from further evaluation and treatment.
OBJECTIVE: The first edition of the American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi Guidelines for the Diagnosis and Management of Thyroid Nodules was published in 2006 and updated in 2010 and 2016. The American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi multidisciplinary thyroid nodules task force was charged with developing a novel interactive electronic algorithmic tool to evaluate thyroid nodules. METHODS: The Thyroid Nodule App (termed TNAPP) was based on the updated 2016 clinical practice guideline recommendations while incorporating recent scientific evidence and avoiding unnecessary diagnostic procedures and surgical overtreatment. This manuscript describes the algorithmic tool development, its data requirements, and its basis for decision making. It provides links to the web-based algorithmic tool and a tutorial. RESULTS:TNAPP and TI-RADS were cross-checked on 95 thyroid nodules with histology-proven diagnoses. CONCLUSION:TNAPP is a novel interactive web-based tool that uses clinical, imaging, cytologic, and molecular marker data to guide clinical decision making to evaluate and manage thyroid nodules. It may be used as a heuristic tool for evaluating and managing patients with thyroid nodules. It can be adapted to create registries for solo practices, large multispecialty delivery systems, regional and national databases, and research consortiums. Prospective studies are underway to validate TNAPP to determine how it compares with other ultrasound-based classification systems and whether it can improve the care of patients with clinically significant thyroid nodules while reducing the substantial burden incurred by those who do not benefit from further evaluation and treatment.
Authors: Katarzyna Dobruch-Sobczak; Zbigniew Adamczewski; Marek Dedecjus; Andrzej Lewiński; Bartosz Migda; Marek Ruchała; Anna Skowrońska-Szcześniak; Ewelina Szczepanek-Parulska; Klaudia Zajkowska; Agnieszka Żyłka Journal: J Ultrason Date: 2022-04-27
Authors: Sara Ahmadi; Theodora Pappa; Alex S Kang; Alexandra K Coleman; Iñigo Landa; Ellen Marqusee; Matthew Kim; Trevor E Angell; Erik K Alexander Journal: Front Endocrinol (Lausanne) Date: 2022-02-11 Impact factor: 5.555