Radionuclide thyroid studies: analysis of use and correlation with physical findings

We assessed all thyroid radionuclide studies done at a single institution during one year and evaluated the indication for ordering each study as well as the concordance of study results with those of physical examination. We found that thyroid radionuclide imaging was overused, with at most 66% of scans being indicated (using the most generous classification of a proposed rating for indications). Radioactive iodine uptake measurement done without scanning was probably underused. Concordance between the results of physical examination and scanning was reflected by an overall agreement rate of 51%; agreement between results of scanning and physical examination beyond what might be expected by chance alone was reflected by a kappa value of .34. Concordance was strongest for diffuse goiters and weakest for normal findings.