American Association of Clinical Endocrinology And Associazione Medici Endocrinologi Thyroid Nodule Algorithmic Tool

Jeffrey R. Garber*, Enrico Papini, Andrea Frasoldati, Mark A. Lupo, R. Mack Harrell, Sareh Parangi, Vivek Patkar, Zubair W. Baloch, Rachel Pessah-Pollack, Laszlo Hegedus, Anna Crescenzi, Carrie C. Lubitz, Ralf Paschke, Gregory W. Randolph, Rinaldo Guglielmi, Celestino P. Lombardi, Hossein Gharib

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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.

Original languageEnglish
JournalEndocrine Practice
Volume27
Issue number7
Pages (from-to)649-660
ISSN1530-891X
DOIs
Publication statusPublished - Jul 2021

Bibliographical note

Publisher Copyright:
© 2021 AACE

Keywords

  • algorithms
  • diagnostic techniques
  • fine-needle aspiration
  • internet
  • practice guidelines

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