US-based risk stratification "guidelines" for thyroid nodules: Quō Vādis?

Area of Science:

• Endocrinology
• Radiology
• Medical Informatics

Background:

• The proliferation of guidelines for managing adult thyroid nodules (GMTNs) presents challenges.
• The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS™-2017) is one such guideline, but its role and consistency are debated.

Purpose of the Study:

• To conduct a rapid scoping review evaluating the commentary on the ACR TI-RADS™-2017.
• To assess the landscape of existing guidelines for managing adult thyroid nodules.

Main Methods:

• A rapid scoping review of peer-reviewed articles comparing two or more guidelines for managing adult thyroid nodules (GMTNs) was performed.
• Searches were conducted in Medline (PubMed), EBSCO, Google, and Google Scholar for articles published between 2010 and 2019.

Main Results:

• Twelve distinct guidelines were identified across 28 reviewed articles.
• Most articles focused on diagnostic performance (26/28) rather than quality measures (2/28).
• Commonly reviewed guidelines included ATA-2015, ACR TI-RADS™-2017, South Korean, and EU TI-RADS, with no single guideline universally accepted.

Conclusions:

• A significant number of guidelines for managing adult thyroid nodules (GMTNs) are available.
• No single guideline has achieved general acceptance, and their performance and quality evaluations are inconsistent.