Survey of management of solitary thyroid nodules in Germany.
OBJECTIVE
To compare the opinions of practitioners in primary care with those of thyroid specialists in Germany on the management of solitary thyroid nodules (Papillon 2005).


METHODS
Questionnaires were filled in by 2,191 practitioners and 297 thyroid specialists between June 1 and September 30, 2005. The test cases and their modifications described a solitary thyroid nodule of 2-3 cm with different levels of thyroid function and a hypoechogenic nodule of 1 cm in diameter.


RESULTS
TSH determination and sonography were found to be standard procedures, followed by scintigraphy (selected by 84.7% of practitioners and 95.1% of specialists, p < 0.001) and fine needle aspiration cytology (54.5% of practitioners, 57.4% of specialists). For a hypoechogenic nodule calcitonin determination was advocated by 54.0% of endocrinologists and by 32.2% of nuclear medicine physicians (p < 0.001). A euthyroid solitary thyroid nodule would be treated medically by 77.8% of practitioners and by 85.7% of specialists, the combination of levothyroxine and iodine being clearly preferred (60.9% of practitioners and 67.1% of specialists). For a hyperfunctioning nodule the preference of radioiodine therapy was significantly higher in the specialist group (88.8%) than among the practitioners (52.2%).


CONCLUSIONS
The main differences of opinion between practitioners and specialists focused on calcitonin screening and referral to radioiodine therapy.
Dietlein
M
M
Department of Nuclear Medicine, University of Cologne, Kerpener Str. 62, 50924 Cologne, Germany. markus.dietlein@uni-koeln.de
Wegscheider
K
K
Vaupel
R
R
Schmidt
M
M
Schicha
H
H
D005194:Family Practice; D005858:Germany; D006801:Humans; D008511:Medicine; D009683:Nuclear Medicine; D011877:Radionuclide Imaging; D012016:Reference Values; D013038:Specialization; D011795:Surveys and Questionnaires; D016606:Thyroid Nodule / Q000145:classification / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D013972:Thyrotropin / Q000097:blood
D013972:Thyrotropin