Who Is Diagnosing Pediatric Thyroid Nodules? A Tertiary Children's Hospital Review.

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Otolaryngology- Head and Neck Surgery Pub Date : 2025-07-01 Epub Date: 2025-03-19 DOI:10.1002/ohn.1232
Joy M Justice, Janavi Sethurathnam, Nanda Nayak, Heidi Chen, Kalpnaben Patel, Sara Bartz, Christopher Baron, Barron Patterson, Ryan H Belcher
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Abstract

Objective: The incidence of pediatric thyroid cancer has increased. Little is documented about which providers are diagnosing pediatric thyroid nodules and how this impacts care. Our objective was to analyze how nodules are identified and how diagnosing provider type impacts nodule size and management.

Study design: Retrospective chart review.

Setting: Tertiary care children's hospital.

Methods: Pediatric patients (aged 0-17) with at least one thyroid nodule diagnosed between 2006 and 2023 were reviewed. Diagnosing provider type, diagnostic method, nodule size, clinical management, and final diagnosis were analyzed.

Results: The study included 351 patients. Primary care providers diagnosed the largest proportion of nodules (43.0%), followed by incidental nodules by radiologists (24.2%). The proportion diagnosed by radiologists increased from 12% to 31% after 2017 (P < .001). Primary care providers were more likely to use physical exam than pediatric endocrinologists (65% vs 42%, P = .004), who more often used ultrasound (56% vs 37%, P = .02). Primary care providers diagnosed nodules with a median diameter of 1.50 cm, larger than that of pediatric endocrinologists and radiologists, both 0.8 cm (P = .01, P < .001). Compared to patients diagnosed by radiologists, patients diagnosed by primary care providers more often underwent biopsy (P = .02) or surgery (P < .001) and received a malignant diagnosis (P = .001).

Conclusion: Primary care providers play a key role in detecting pediatric thyroid nodules, and a physical exam is vital in identifying significant pathology. Radiologic incidental nodules increased in frequency over our study timespan. Future research should consider the impact of socioeconomic status or geographic location on nodule size and management.

谁来诊断儿童甲状腺结节?三级儿童医院综述
目的:小儿甲状腺癌的发病率呈上升趋势。关于哪些提供者诊断小儿甲状腺结节以及这如何影响护理的记录很少。我们的目标是分析如何识别结节,以及诊断提供者类型如何影响结节大小和管理。研究设计:回顾性图表回顾。环境:三级保健儿童医院。方法:回顾性分析2006年至2023年间诊断出至少一个甲状腺结节的儿童患者(0-17岁)。分析诊断提供者类型、诊断方法、结节大小、临床处理及最终诊断结果。结果:共纳入351例患者。初级保健提供者诊断的结节比例最大(43.0%),其次是放射科医生诊断的偶发结节(24.2%)。结论:初级保健提供者在发现儿童甲状腺结节中起着关键作用,体格检查对于发现重要病理至关重要。在我们的研究期间,放射学偶发结节的频率增加。未来的研究应考虑社会经济地位或地理位置对结节大小和管理的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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