ATA practice guidelines for the treatment of differentiated thyroid cancer: were they followed in the United States? Am J Surg 2010 Feb;199(2):189-98
Date
02/02/2010Pubmed ID
20113699DOI
10.1016/j.amjsurg.2009.04.022Scopus ID
2-s2.0-74549167389 (requires institutional sign-in at Scopus site) 41 CitationsAbstract
BACKGROUND: The aim of this study was to benchmark national practice patterns against American Thyroid Association guidelines for thyroidectomy, lymphadenectomy, and radioactive iodine (RAI) for differentiated thyroid cancer (DTC).
METHODS: A cross-sectional analysis of patients with DTC in Surveillance, Epidemiology, and End Results was performed. Outcomes were practice accordance with guidelines for extent of surgery and RAI treatment. Predictors of accordance were identified.
RESULTS: A total of 52,964 patients with DTC were included. Seventy-six percent were women, and 83% white. There was 71% accordance with surgery recommendations; among these, 15% underwent central lymphadenectomy, 31% had RAI but no lymphadenectomy, and 25% had RAI and lymphadenectomy. The highest accordance with guidelines was for patients aged <45 years with stage II disease (80%); the lowest accordance was for patients aged > or = 45 years with stage II disease (52%). Patients aged >65 years and of black race had the lowest accordance (P < .001).
CONCLUSIONS: Variation in practice suggests variation in the quality of care for DTC. Greater dissemination of evidence-based recommendations is needed for elderly and minority patients.
Author List
Famakinwa OM, Roman SA, Wang TS, Sosa JAAuthor
Tracy S. Wang MPH, MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Benchmarking
Cross-Sectional Studies
Female
Guideline Adherence
Humans
Iodine Radioisotopes
Lymph Node Excision
Male
Middle Aged
Multivariate Analysis
Societies, Medical
Thyroid Neoplasms
Thyroidectomy
United States
