Division of Endocrinology, Department of Medicine, University of Florida, Gainesville.
Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine.
Curr Opin Endocrinol Diabetes Obes. 2023 Oct 1;30(5):225-230. doi: 10.1097/MED.0000000000000814. Epub 2023 Jun 8.
Thyroid ultrasound (TUS) is a common diagnostic test that can help guide the management of patients with thyroid conditions. Yet, inappropriate use of TUS can lead to harmful unintended consequences. This review aims to describe trends in the use and appropriateness of TUS in practice, drivers and consequences of inappropriate use, and potential solutions to decrease overuse.
TUS use has increased in the U.S. and is associated with increased diagnosis of thyroid cancer. Between 10-50% of TUSs may be ordered outside of clinical practice recommendations. Patients who receive an inappropriate TUS and are incidentally found to have a thyroid nodule may experience unnecessary worry, diagnostic interventions, and potential overdiagnosis of thyroid cancer. The drivers of inappropriate TUS use are not yet fully understood, but it is likely that a combination of clinician, patient, and healthcare system factors contribute to this problem.
Inappropriate TUS is a factor leading to the overdiagnosis of thyroid nodules and thyroid cancer, resulting in increased healthcare costs and potential harm to patients. To effectively address the overuse of this diagnostic test, it is necessary to gain a deeper understanding of the frequency of inappropriate TUS use in clinical practice and the factors that contribute to it. With this knowledge, interventions can be developed to reduce the inappropriate use of TUS, leading to improved patient outcomes and more efficient use of healthcare resources.
甲状腺超声（TUS）是一种常见的诊断测试，可以帮助指导甲状腺疾病患者的管理。然而，不恰当地使用 TUS 可能会导致有害的意外后果。本综述旨在描述 TUS 在实践中的使用和适当性的趋势、不适当使用的驱动因素和后果，以及减少过度使用的潜在解决方案。
在美国，TUS 的使用有所增加，并且与甲状腺癌的诊断增加有关。在 10-50%的 TUS 可能是在临床实践建议之外开具的。接受不适当的 TUS 检查并偶然发现甲状腺结节的患者可能会经历不必要的担忧、诊断干预以及甲状腺癌的过度诊断的潜在风险。不适当的 TUS 使用的驱动因素尚未完全了解，但临床医生、患者和医疗保健系统因素的组合可能导致了这个问题。
不适当的 TUS 是导致甲状腺结节和甲状腺癌过度诊断的一个因素，导致医疗保健成本增加，并可能对患者造成潜在危害。为了有效地解决这种诊断测试的过度使用问题，有必要更深入地了解不适当的 TUS 在临床实践中的使用频率及其促成因素。有了这些知识，可以制定干预措施来减少 TUS 的不适当使用，从而改善患者的结果并更有效地利用医疗保健资源。
