TUESDAY, Aug. 25, 2020 — As many as one-third of doctors may be sending patients for a thyroid ultrasound for reasons not supported by guidelines, a new study finds.
The use of ultrasound to detect thyroid cancer has led to a large increase in thyroid cancer cases, but many of these cancers are low-risk and won’t cause serious harm, the study authors explained.
For the study, the researchers questioned 610 surgeons, endocrinologists and primary care doctors involved in thyroid cancer care.
Most doctors said they used ultrasound for reasons that are supported by guidelines, such as a large nodule that can be felt or one seen on another imaging test.
But 33% said they prescribed an ultrasound because the patient wanted it and 28% said an abnormal thyroid function test influenced their decision.
“This study is the first to look at why physicians are using thyroid ultrasound for patients. While often it’s for clinically relevant reasons, a substantial number of physicians are not ordering them for reasons that are clinically supported,” said researcher Dr. Megan Haymart. She’s a professor of internal medicine at Michigan Medicine, in Ann Arbor.
Most doctors (69%) said clinical guidelines influenced their decisions for patients with thyroid nodules.
Haymart said this shows that doctors can be influenced. “We can change behavior and help physicians use thyroid ultrasound more appropriately, which will reduce the incidence of low-risk thyroid cancer,” she said.
That doctors order thyroid ultrasounds because patients want them suggests more education and discussion is needed, Haymart added.
“There’s so much emphasis in medicine on patient satisfaction. You do want patients to be satisfied, but physicians also have to do what’s medically appropriate,” she said in a University of Michigan news release. “Developing decision aids could help patients understand and decide when thyroid ultrasound is appropriate and when it’s not.”
The report was published online recently in JAMA Surgery.
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Posted: August 2020