Practice test of the German S3 guideline "Thyroid Nodules in Adults in General Practice": Evaluating feasibility,...

Thyroid nodules are commonly discovered incidentally during routine examinations in general practice, which often leads to extensive diagnostics and overtreatment. To provide general practitioners (GPs) with evidence-based guidance on the diagnosis and management of thyroid nodules, the S3 guideline "Thyroid Nodules in Adults" by the German Society for General and Family Medicine (DEGAM) was developed in three versions: a short, a long, and a patient leaflet format. An assessment of the effectiveness of the guideline in general practice was undertaken.

We ran a practice test in 17 general practices, yielding data from 17 GPs and 94 patients. Quantitative data were collected using documentation forms and questionnaires for GPs and patients. Two semi-structured online workshops provided qualitative data. Data were analyzed using descriptive statistics and qualitative content analysis.

About 50 % of GPs reported modifying their diagnostic methods, while therapy adjustments were reported in 21 % of the consultations. The patient leaflet received positive feedback from patients and GPs, but both groups requested more detailed content. The workshops revealed challenges, including limited consultation time, difficulties in explaining extended follow-up intervals to patients, and differences in approaches between primary care and specialist services.

The guideline proved applicable in practice. The feedback served ongoing improvements, including plans for supportive tools like conversation guides, case examples, and training materials.

The practice test showed the level of guideline comprehensibility and acceptance in general practice, highlighting areas of improvement. These include clearer communication with patients, interprofessional alignment and modification of materials according to patient requirements.