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[Diagnosis of thyroid nodule. Application of evidence-based medicine]
N Guevara1, L Castillo, J Santini
1Service d'ORL et de chirurgie de la Face et du Cou, Hôpital Pasteur, 30 avenue de la Voie Romaine BP 69, 06002 Nice Cedex 1. nicolas.guevara@wanadoo.fr
Objective:
The frequency of thyroid nodules requires an appropriate and consistent undertaking of such pathology by the entire medical profession. Over the past few years, the ANAES (National Agency of Health Accreditation and Evaluation - 1995 - 1997) had formulated medical recommendations. Our work aimed at updating such recommendations considering recent literature developments and their level of evidence.
Material And Methods:
We have selected high-level of evidence's articles published since 1997 dealing with the diagnostic undertaking of thyroid nodule. Such analysis was conducted using the search engine "Medline" and the level of evidence of the selected articles was evaluated by taking into account the professional recommendations of the "literature analysis and gradation of recommendations' guide" of ANAES.
Result:
At present, two diagnostic tests are necessary in the diagnostic evaluation of a thyroid nodule (ultrasonography and fine-needle aspiration).
Conclusion:
The medical recommendation will hence result in the synthesis of these two different diagnostic tests, nevertheless fine-needle aspiration being essential and having priority in evaluating the risk of cancer.
