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Diagnostic accuracy of palpation versus ultrasound-guided fine needle aspiration biopsy for diagnosis of malignancy in thyroid nodules: a systematic review and meta-analysis
Thyroid nodule is a common health problem in endocrinology. Thyroid fine-needle aspiration biopsy (FNAB) cytology performed by palpation guided FNAB (PGFNAB) and ultrasound-guided FNAB (USGFNAB) are the preferred examinations for the diagnosis of thyroid cancer and part of the integration of the cur...
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Published in: | BMC endocrine disorders 2022-07, Vol.22 (1), p.1-181, Article 181 |
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description | Thyroid nodule is a common health problem in endocrinology. Thyroid fine-needle aspiration biopsy (FNAB) cytology performed by palpation guided FNAB (PGFNAB) and ultrasound-guided FNAB (USGFNAB) are the preferred examinations for the diagnosis of thyroid cancer and part of the integration of the current thyroid nodule assessment. Although studies have shown USGFNAB to be more accurate than PGFNAB, inconsistencies from several studies and clinical guidelines still exist.
The purpose of this study is to compare the diagnostic accuracy of Palpation versus Ultrasound-Guided Fine Needle Aspiration Biopsy in diagnosing malignancy of thyroid nodules.
The systematic review and meta-analysis were prepared based on the PRISMA standards. Literature searches were carried out on three online databases (Pubmed/MEDLINE, Embase, and Proquest) and grey literatures. Data extraction was carried out manually from various studies that met the eligibility, followed by analysis to obtain pooled data on sensitivity, specificity, Diagnostic Odds Ratio (DOR) and Area Under Curve (AUC), and the comparison of the two methods.
Total of 2517 articles were obtained, with 11 studies were included in this systematic review. The total sample was 2382, including 1128 subjects using PGFNAB and 1254 subjects using USGFNAB. The risk of bias was assessed using QUADAS-2 with mild-moderate results. The results of sensitivity, specificity, AUC and DOR in diagnosing thyroid nodules using PGFNAB were 76% (95% CI, 49–89%), 77% (95% CI, 56–95%), 0.827 and 11.6 (95% CI, 6–21) respectively. The results of sensitivity, specificity, AUC and DOR in diagnosing thyroid nodules using USGFNAB were 90% (95% CI, 81–95%), 80% (95% CI, 66–89%), 0.92 and 40 (95% CI, 23–69), respectively the results of the comparison test between PGFNAB and USGFNAB; Tsens USGFNAB of 0.99 (
p
= 0.023), AUC difference test of 0.093 (
p
= 0.000023).
The diagnostic accuracy of USGFNAB is higher than PGFNAB in diagnosing malignancy of thyroid nodules. If it is accessible, the author recommends using USGFNAB as a diagnostic tool for thyroid nodules. |
doi_str_mv | 10.1186/s12902-022-01085-5 |
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The purpose of this study is to compare the diagnostic accuracy of Palpation versus Ultrasound-Guided Fine Needle Aspiration Biopsy in diagnosing malignancy of thyroid nodules.
The systematic review and meta-analysis were prepared based on the PRISMA standards. Literature searches were carried out on three online databases (Pubmed/MEDLINE, Embase, and Proquest) and grey literatures. Data extraction was carried out manually from various studies that met the eligibility, followed by analysis to obtain pooled data on sensitivity, specificity, Diagnostic Odds Ratio (DOR) and Area Under Curve (AUC), and the comparison of the two methods.
Total of 2517 articles were obtained, with 11 studies were included in this systematic review. The total sample was 2382, including 1128 subjects using PGFNAB and 1254 subjects using USGFNAB. The risk of bias was assessed using QUADAS-2 with mild-moderate results. The results of sensitivity, specificity, AUC and DOR in diagnosing thyroid nodules using PGFNAB were 76% (95% CI, 49–89%), 77% (95% CI, 56–95%), 0.827 and 11.6 (95% CI, 6–21) respectively. The results of sensitivity, specificity, AUC and DOR in diagnosing thyroid nodules using USGFNAB were 90% (95% CI, 81–95%), 80% (95% CI, 66–89%), 0.92 and 40 (95% CI, 23–69), respectively the results of the comparison test between PGFNAB and USGFNAB; Tsens USGFNAB of 0.99 (
p
= 0.023), AUC difference test of 0.093 (
p
= 0.000023).
The diagnostic accuracy of USGFNAB is higher than PGFNAB in diagnosing malignancy of thyroid nodules. If it is accessible, the author recommends using USGFNAB as a diagnostic tool for thyroid nodules.</description><identifier>ISSN: 1472-6823</identifier><identifier>EISSN: 1472-6823</identifier><identifier>DOI: 10.1186/s12902-022-01085-5</identifier><identifier>PMID: 35843955</identifier><language>eng</language><publisher>London: BioMed Central Ltd</publisher><subject>Accuracy ; Analysis ; Bias ; Biopsy ; Cancer ; Cytology ; Diagnosis ; Endocrinology ; Fine-needle aspiration biopsy ; Grey literature ; Histopathology ; Malignancy ; Meta-analysis ; Nodules ; Oncology, Experimental ; Palpable versus USG guided ; Patients ; Practice guidelines (Medicine) ; Researchers ; Reviews ; Software ; Statistical analysis ; Surgery ; Systematic review ; Thyroid cancer ; Thyroid gland ; Thyroid nodules ; Ultrasonic imaging ; Ultrasound</subject><ispartof>BMC endocrine disorders, 2022-07, Vol.22 (1), p.1-181, Article 181</ispartof><rights>COPYRIGHT 2022 BioMed Central Ltd.</rights><rights>2022. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-41687a5df149c72384183c02116271346f5b08daf5c8b75d67a1aa931f5ebc743</citedby><cites>FETCH-LOGICAL-c540t-41687a5df149c72384183c02116271346f5b08daf5c8b75d67a1aa931f5ebc743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290285/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2691529992?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids></links><search><creatorcontrib>Tarigan, Tri Juli Edi</creatorcontrib><creatorcontrib>Anwar, Budiman Syaeful</creatorcontrib><creatorcontrib>Sinto, Robert</creatorcontrib><creatorcontrib>Wisnu, Wismandari</creatorcontrib><title>Diagnostic accuracy of palpation versus ultrasound-guided fine needle aspiration biopsy for diagnosis of malignancy in thyroid nodules: a systematic review and meta-analysis</title><title>BMC endocrine disorders</title><description>Thyroid nodule is a common health problem in endocrinology. Thyroid fine-needle aspiration biopsy (FNAB) cytology performed by palpation guided FNAB (PGFNAB) and ultrasound-guided FNAB (USGFNAB) are the preferred examinations for the diagnosis of thyroid cancer and part of the integration of the current thyroid nodule assessment. Although studies have shown USGFNAB to be more accurate than PGFNAB, inconsistencies from several studies and clinical guidelines still exist.
The purpose of this study is to compare the diagnostic accuracy of Palpation versus Ultrasound-Guided Fine Needle Aspiration Biopsy in diagnosing malignancy of thyroid nodules.
The systematic review and meta-analysis were prepared based on the PRISMA standards. Literature searches were carried out on three online databases (Pubmed/MEDLINE, Embase, and Proquest) and grey literatures. Data extraction was carried out manually from various studies that met the eligibility, followed by analysis to obtain pooled data on sensitivity, specificity, Diagnostic Odds Ratio (DOR) and Area Under Curve (AUC), and the comparison of the two methods.
Total of 2517 articles were obtained, with 11 studies were included in this systematic review. The total sample was 2382, including 1128 subjects using PGFNAB and 1254 subjects using USGFNAB. The risk of bias was assessed using QUADAS-2 with mild-moderate results. The results of sensitivity, specificity, AUC and DOR in diagnosing thyroid nodules using PGFNAB were 76% (95% CI, 49–89%), 77% (95% CI, 56–95%), 0.827 and 11.6 (95% CI, 6–21) respectively. The results of sensitivity, specificity, AUC and DOR in diagnosing thyroid nodules using USGFNAB were 90% (95% CI, 81–95%), 80% (95% CI, 66–89%), 0.92 and 40 (95% CI, 23–69), respectively the results of the comparison test between PGFNAB and USGFNAB; Tsens USGFNAB of 0.99 (
p
= 0.023), AUC difference test of 0.093 (
p
= 0.000023).
The diagnostic accuracy of USGFNAB is higher than PGFNAB in diagnosing malignancy of thyroid nodules. If it is accessible, the author recommends using USGFNAB as a diagnostic tool for thyroid nodules.</description><subject>Accuracy</subject><subject>Analysis</subject><subject>Bias</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Cytology</subject><subject>Diagnosis</subject><subject>Endocrinology</subject><subject>Fine-needle aspiration biopsy</subject><subject>Grey literature</subject><subject>Histopathology</subject><subject>Malignancy</subject><subject>Meta-analysis</subject><subject>Nodules</subject><subject>Oncology, Experimental</subject><subject>Palpable versus USG guided</subject><subject>Patients</subject><subject>Practice guidelines (Medicine)</subject><subject>Researchers</subject><subject>Reviews</subject><subject>Software</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Thyroid cancer</subject><subject>Thyroid gland</subject><subject>Thyroid nodules</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><issn>1472-6823</issn><issn>1472-6823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkk2P1SAUhhujccarf8AViRs3HYGWFlyYTMavSSZxo2tyykeHmxYqtNf0R_kf5d5O1GsMIZDDex4Oh7coXhJ8RQhv3iRCBaYlpnkSzFnJHhWXpG5p2XBaPf5rf1E8S2mPMWk5xU-Li4rxuhKMXRY_3zvofUizUwiUWiKoFQWLJhgmmF3w6GBiWhJahjlCCovXZb84bTSyzhvkjdGDQZAmFzd958KUVmRDRHpju3QkjjC43oPPfOfRfL_G4DTyQS-DSW8RoLSm2YxwrCSagzM_EHiNRjNDCR6GNXOeF08sDMm8eFh3xbePH77efC7vvny6vbm-KxWr8VzWpOEtMG1JLVRLK14TXilMCWloS6q6sazDXINlinct000LBEBUxDLTqbaudsXtxtUB9nKKboS4ygBOngIh9hJiLnQw0nSVqjUoIbSocauhq6nlOdS0RlvOMuvdxpqWbjRaGZ8bOZxBz0-8u5d9OEhx_N0T4PUDIIbvi0mzHF1SZhjAm7AkSRtB6oY2VGTpq3-k-7DE3LxNxagQgv5R9ZAf4LwN-V51hMrrluCG4ir3a1dc_UeVhzajU8Eb63L8LIFuCSqGlKKxv99IsDwaVm6Gldmw8mRYyapfE7_f6Q</recordid><startdate>20220717</startdate><enddate>20220717</enddate><creator>Tarigan, Tri Juli Edi</creator><creator>Anwar, Budiman Syaeful</creator><creator>Sinto, Robert</creator><creator>Wisnu, Wismandari</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20220717</creationdate><title>Diagnostic accuracy of palpation versus ultrasound-guided fine needle aspiration biopsy for diagnosis of malignancy in thyroid nodules: a systematic review and meta-analysis</title><author>Tarigan, Tri Juli Edi ; Anwar, Budiman Syaeful ; Sinto, Robert ; Wisnu, Wismandari</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-41687a5df149c72384183c02116271346f5b08daf5c8b75d67a1aa931f5ebc743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Accuracy</topic><topic>Analysis</topic><topic>Bias</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Cytology</topic><topic>Diagnosis</topic><topic>Endocrinology</topic><topic>Fine-needle aspiration biopsy</topic><topic>Grey literature</topic><topic>Histopathology</topic><topic>Malignancy</topic><topic>Meta-analysis</topic><topic>Nodules</topic><topic>Oncology, Experimental</topic><topic>Palpable versus USG guided</topic><topic>Patients</topic><topic>Practice guidelines (Medicine)</topic><topic>Researchers</topic><topic>Reviews</topic><topic>Software</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Systematic review</topic><topic>Thyroid cancer</topic><topic>Thyroid gland</topic><topic>Thyroid nodules</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tarigan, Tri Juli Edi</creatorcontrib><creatorcontrib>Anwar, Budiman Syaeful</creatorcontrib><creatorcontrib>Sinto, Robert</creatorcontrib><creatorcontrib>Wisnu, Wismandari</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>BMC endocrine disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tarigan, Tri Juli Edi</au><au>Anwar, Budiman Syaeful</au><au>Sinto, Robert</au><au>Wisnu, Wismandari</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic accuracy of palpation versus ultrasound-guided fine needle aspiration biopsy for diagnosis of malignancy in thyroid nodules: a systematic review and meta-analysis</atitle><jtitle>BMC endocrine disorders</jtitle><date>2022-07-17</date><risdate>2022</risdate><volume>22</volume><issue>1</issue><spage>1</spage><epage>181</epage><pages>1-181</pages><artnum>181</artnum><issn>1472-6823</issn><eissn>1472-6823</eissn><abstract>Thyroid nodule is a common health problem in endocrinology. Thyroid fine-needle aspiration biopsy (FNAB) cytology performed by palpation guided FNAB (PGFNAB) and ultrasound-guided FNAB (USGFNAB) are the preferred examinations for the diagnosis of thyroid cancer and part of the integration of the current thyroid nodule assessment. Although studies have shown USGFNAB to be more accurate than PGFNAB, inconsistencies from several studies and clinical guidelines still exist.
The purpose of this study is to compare the diagnostic accuracy of Palpation versus Ultrasound-Guided Fine Needle Aspiration Biopsy in diagnosing malignancy of thyroid nodules.
The systematic review and meta-analysis were prepared based on the PRISMA standards. Literature searches were carried out on three online databases (Pubmed/MEDLINE, Embase, and Proquest) and grey literatures. Data extraction was carried out manually from various studies that met the eligibility, followed by analysis to obtain pooled data on sensitivity, specificity, Diagnostic Odds Ratio (DOR) and Area Under Curve (AUC), and the comparison of the two methods.
Total of 2517 articles were obtained, with 11 studies were included in this systematic review. The total sample was 2382, including 1128 subjects using PGFNAB and 1254 subjects using USGFNAB. The risk of bias was assessed using QUADAS-2 with mild-moderate results. The results of sensitivity, specificity, AUC and DOR in diagnosing thyroid nodules using PGFNAB were 76% (95% CI, 49–89%), 77% (95% CI, 56–95%), 0.827 and 11.6 (95% CI, 6–21) respectively. The results of sensitivity, specificity, AUC and DOR in diagnosing thyroid nodules using USGFNAB were 90% (95% CI, 81–95%), 80% (95% CI, 66–89%), 0.92 and 40 (95% CI, 23–69), respectively the results of the comparison test between PGFNAB and USGFNAB; Tsens USGFNAB of 0.99 (
p
= 0.023), AUC difference test of 0.093 (
p
= 0.000023).
The diagnostic accuracy of USGFNAB is higher than PGFNAB in diagnosing malignancy of thyroid nodules. If it is accessible, the author recommends using USGFNAB as a diagnostic tool for thyroid nodules.</abstract><cop>London</cop><pub>BioMed Central Ltd</pub><pmid>35843955</pmid><doi>10.1186/s12902-022-01085-5</doi><oa>free_for_read</oa></addata></record> |
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subjects | Accuracy Analysis Bias Biopsy Cancer Cytology Diagnosis Endocrinology Fine-needle aspiration biopsy Grey literature Histopathology Malignancy Meta-analysis Nodules Oncology, Experimental Palpable versus USG guided Patients Practice guidelines (Medicine) Researchers Reviews Software Statistical analysis Surgery Systematic review Thyroid cancer Thyroid gland Thyroid nodules Ultrasonic imaging Ultrasound |
title | Diagnostic accuracy of palpation versus ultrasound-guided fine needle aspiration biopsy for diagnosis of malignancy in thyroid nodules: a systematic review and meta-analysis |
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