Diagnostic accuracy of thyroid nodule growth to predict XXXX in thyroid nodules with benign cytology: Systematic review and meta-analysis.

@entity1 @entity259 @entity5
BACKGROUND: Thyroid ultrasound to assess for nodular growth is commonly performed during the follow-up of @entity1 with benign thyroid nodules, with the goal of identifying @entity1 with a missed diagnosis of @entity259 . The objective of this study was to summarise the evidence regarding the diagnostic accuracy of growth during follow-up of benign thyroid nodules for @entity259 . METHODS: We searched multiple electronic databases using a search strategy designed by an experienced medical librarian from inception to March 2015. Eligible studies included @entity1 with benign thyroid nodules assessed for growth during follow-up and evaluated for @entity259 either by surgical histology or a repeat fine needle aspiration biopsy. Reviewers working independently and in duplicate recorded data and assessed each study. RESULTS: The 7 eligible studies lacked safeguards against bias and generated results that were imprecise with wide confidence intervals and inconsistent across studies. This warrants very low confidence in these results. The odds of @entity259 on histopathology in @entity1 with nodule growth over the odds in @entity1 without nodule growth (diagnostic odds ratio) was 0.58 (95% CI: 0.26 to 1.3); the diagnostic odds ratio was 2.2 (95% CI: 0.26 to 18) when an abnormal repeat biopsy was the reference standard. CONCLUSION: The body of evidence linking nodule growth with @entity259 during the follow-up of benign nodules warrants very low confidence. In the era of high value healthcare, the commonplace practice of following benign thyroid nodules with serial ultrasound assessment of growth to diagnose @entity5 can be questioned, calling for imminent evaluation. This article is protected by copyright. All rights reserved.
