Evaluation of thyroid ultrasound reports' quality in the Community of Madrid, Spain

To evaluate the current quality of thyroid ultrasound reports in the Community of Madrid.

Consecutive thyroid ultrasound reports from patients evaluated in the endocrine outpatient clinics of eight academic hospitals in the Community of Madrid were assessed for quality during 2021 and 2022. Descriptions of eight different features were evaluated: number and axes of dimensions, composition, echogenicity, margins, shape, calcifications and category of suspicion. Features were considered adequately reported if described for all nodules ≥1 cm. The number of correctly reported features was compared by year of data capture (2021 vs 2022), specialty of the informant (radiologist vs endocrinologist), and origin of the report (in-house vs outsourced center). The quality of reports for assessing the need for cytological evaluation and/or growth during follow-up was evaluated.

A total of 1234 reports were included, 63% from 2021; 82% were issued by radiologists and 89% were issued in-house. Composition and echogenicity were the most frequently reported (79% and 72%, respectively). The rest of the features were appropriately described in less than half of the reports. Forty percent of the reports were good to select nodules for biopsy, 23% had sufficient data to assess growth during follow-up, and only 13% met both quality criteria. The overall quality of reports was worse in outsourced centers (median number of described features 2 vs 4, P < 0.001) and better when issued by endocrinologists (median number of described features 6 vs 3, P < 0.001).

Most thyroid ultrasound reports issued in the Community of Madrid provide insufficient data to make management decisions regarding thyroid nodules.