Wenzel K W, Riedemann J H
Dtsch Med Wochenschr. 1981 Nov 13;106(46):1526-32. doi: 10.1055/s-2008-1070547.
Measures prior to diagnosis and treatment already installed were assessed retrospectively in 8501 patients with suspect thyroid disease between the years 1976 and 1979. In 10.5% of these patients there were 11.2% misdiagnosis or wrong treatment. The most common misdiagnoses were hyperthyroidism in euthyroid patients (1.9%), hypothyroidism in euthyroidism (0.8%), non-recognition or non-aspiration of cold nodules (0.9%), missing a goitre (0.6%). Among diagnostic methods the radio-iodine test was reason for a wrong diagnosis most commonly (66%). The TRH-test proved to be least erroneous, technical reasons being the cause of the 9.6% of misdiagnoses. The most common mismanagements were due to lack of prophylaxis of recurrence after goitre operation (1.5%), external irradiation of the thyroid gland with radium or Roentgen rays (0.7%), and during thyroid hormone treatment of goitre (1.3%). Iatrogenic disease existed mainly as factitious hyperthyroidism (0.7%), non-treated hypothyroidism after treatment with radio-iodine of hyperthyroidism (0.1%), and as goitre recurrence due to lack of prophylaxis of recurrence (0.8% of all patients). As every 10th patient was subjected to misdiagnosis or mismanagement, shifting to endocrinological advisory centers may prevent future mismanagement of thyroid disorders.
1976年至1979年间，对8501例疑似甲状腺疾病患者回顾性评估了诊断和治疗前已采取的措施。这些患者中，10.5%存在11.2%的误诊或不当治疗情况。最常见的误诊包括甲状腺功能正常患者被误诊为甲状腺功能亢进（1.9%）、甲状腺功能正常被误诊为甲状腺功能减退（0.8%）、冷结节未被识别或未进行穿刺（0.9%）、甲状腺肿漏诊（0.6%）。在诊断方法中，放射性碘试验最常导致误诊（66%）。促甲状腺激素释放激素试验被证明错误率最低，9.6%的误诊是由技术原因导致的。最常见的治疗不当原因包括甲状腺肿手术后缺乏复发预防措施（1.5%）、用镭或X射线对甲状腺进行外部照射（0.7%）以及甲状腺肿的甲状腺激素治疗期间（1.3%）。医源性疾病主要表现为人为甲状腺功能亢进（0.7%）、甲状腺功能亢进放射性碘治疗后未治疗的甲状腺功能减退（0.1%）以及由于缺乏复发预防措施导致的甲状腺肿复发（占所有患者的0.8%）。由于每10名患者中就有1名会出现误诊或治疗不当，转诊至内分泌咨询中心可能会预防未来甲状腺疾病的治疗不当。
