Peter A. Singer, MD; David S. Cooper, MD; Gilbert H. Daniels, MD; Paul W. Ladenson, MD; Francis S. Greenspan, MD; Elliot G. Levy, MD; Lewis E. Braverman, MD; Orlo H. Clark, MD; I. Ross McDougall, MB, ChB, PhD; Kenneth V. Ain, MD; Steven G. Dorfman, MD
A set of minimum clinical guidelines for use by primary care physicians in the evaluation and management of patients with thyroid nodules or thyroid cancer was developed by consensus by an 11- member Standards of Care Committee (the authors of the article) of the American Thyroid Association, New York, NY. The participants were selected by the committee chairman and by the president of the American Thyroid Association based on their clinical experience. The committee members represented different geographic areas within the United States, to reflect different practice patterns. The guidelines were developed based on the expert opinion of the committee participants, as well as on previously published information. Each committee participant was initially assigned to write a section of the document and to submit it to the committee chairman, who revised and assembled the sections into a complete draft document, which was then circulated among all committee members for further revision. Several of the committee members further revised and refined the document, which was then submitted to the entire membership of the American Thyroid Association for written comments and suggestions, many of which were incorporated into a final draft document, which was reviewed and approved by the Executive Council of the American Thyroid Association. Arch Intern Med. 1996;156:2165-2172
Between 4% and 7% of individuals in the United States have palpable thyroid nodules.[1] Thyroid nodules are more common in women and increase in frequency with age. Fewer than 10% of solitary nodules are malignant. The physician who encounters a patient with a thyroid nodule must be able to determine its clinical significance, especially with regard to possible malignancy, compression of structures of the neck, or thyroid dysfunction. In this document, important elements of the history, physical examination, and laboratory evaluation are reviewed, and a suggested management strategy is presented. This outline is not intended to be all-inclusive, nor does it preclude additional evaluation, according to the specific clinical situation.
