Thyroid cancer quality of care indicators: A scoping review

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2025-01-27 DOI:10.1016/j.amjsurg.2025.116223

Kimia Ameri, Michelle Kwon, Akie Watanabe, Sam M. Wiseman

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Abstract

Background

Thyroid cancer, the most common endocrine malignancy, has highly variable practice patterns. This scoping review aimed to identify quantitative and qualitative quality of care indicators (QIs) essential for providing optimal care in thyroid cancer management.

Methods

A comprehensive search across MEDLINE, EMBASE, PubMed, and Web of Science identified QIs defining structures, processes, and outcomes in five care phases: pre-diagnosis, diagnosis, treatment, post-treatment surveillance, and end-of-life care.

Results

Of the 3,143 articles screened, 36 were included, yielding 135 unique QIs. Key diagnostic QIs were the use of a standardized ultrasound reporting system (n = 4), diagnostic fine needle aspiration biopsy (FNAB) (n = 3), and FNA cytology reporting with the Bethesda System (n = 3). Common treatment QIs included thyroidectomy by high-volume surgeons (≥10–32 cases/year) (n = 7), preoperative voice assessment for high-risk patients (n = 4), and recurrent laryngeal nerve monitoring (n = 3). Serum thyroglobulin (Tg) monitoring was the primary post-treatment QI for recurrence (n = 2).

Conclusions

Developing an evidence-based QI list can identify care gaps, direct targeted interventions, promote care standardization, and improve outcomes for thyroid cancer patients.

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甲状腺癌护理质量指标：范围综述。

背景：甲状腺癌是最常见的内分泌恶性肿瘤，其治疗模式变化很大。本综述旨在确定定量和定性护理指标（QIs）的质量，为甲状腺癌管理提供最佳护理必不可少。方法：在MEDLINE、EMBASE、PubMed和Web of Science上进行全面搜索，确定了在五个护理阶段定义结构、过程和结果的QIs：诊断前、诊断、治疗、治疗后监测和临终关怀。结果：在筛选的3143篇文章中，有36篇被纳入，产生135个独特的QIs。关键的诊断QIs是使用标准化超声报告系统（n = 4）、诊断细针穿刺活检（n = 3）和Bethesda系统的FNA细胞学报告（n = 3）。常见的治疗QIs包括大容量外科手术甲状腺切除术（≥10-32例/年）（n = 7），高危患者术前语音评估（n = 4），喉返神经监测（n = 3）。血清甲状腺球蛋白（Tg）监测是治疗后复发的主要QI指标（n = 2）。结论：制定循证QI清单可以识别护理差距，指导有针对性的干预措施，促进护理标准化，改善甲状腺癌患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.