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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2013, Number 4

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An Med Asoc Med Hosp ABC 2013; 58 (4)

Preoperative prediction of the malignancy risk thyroid nodules: from Birmingham to Pisa

Kunz MW, Mismar A, Ahmad R, Materazzi G, Berti P, Miccoli P

Language: Spanish
References: 38
Page: 221-231
PDF size: 279.39 Kb.


ABSTRACT

Introduction: Thyroid nodules are an increasingly common phenomenon with incidence ranging from 19-76% yet, less than 5% of these are malignant. Boelaert and colleagues designed a formula to determine the risk of malignancy in thyroid nodules considering simple clinical variables and serum TSH concentration. We aimed to externally validate this formula within an endocrine surgery referral center. Methods: We included patients submitted to thyroidectomy within a 3 month period at the second Department of Surgery of the University of Pisa, Italy; calculating the predicted risk of malignancy and the actual histopathology diagnosis, therefore, obtaining sensitivity, specificity and predictive values for the formula. Results: Of the 399 patients were included, 169 (42.35%) with thyroid carcinoma. The predicted probability of malignancy correlated with an actual diagnosis (p = 0.0006 95%, CI 0.54-65). However, we determine high specificity but low positive predictive value and sensitivity. Through logistic regression analysis we designed a new formula with better performance (AUC 0.956, CI 95% 0.78-0.997, sensitivity 96.2%, specificity 89.7, PPV 86.16 and NPV 97.25 considering a criterion › 0.4065). Conclusion: The formula designed by Boelaert and colleagues could not be validated as a useful tool in the clinical setting, therefore we propose a new formula to be validated within our context.


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