目的

探讨甲状腺规范化扫查和甲状腺影像报告和数据系统（C-TIRADS）分类推广工作在提高北京市海淀区二级和一级医疗机构甲状腺超声诊断符合率中的作用。

方法

北京市海淀区超声医学质量控制和改进中心（简称质控中心）于2023 年7 月至2024 年6 月开展了为期1 年的甲状腺规范化检查培训及C-TIRADS 分类推广工作。分别于基线时和培训后以线上调查问卷的方式，对辖区内各二级和一级医院甲状腺超声检查C-TIRADS 分类使用情况和超声诊断符合率进行调查，并采用t 检验比较二级医院与一级医院、基线时与培训后的超声诊断符合率差异。

结果

最终纳入有效问卷59 份。基线时，C-TIRADS 分类使用率为30.5%（18/59）；培训后，C-TIRADS 分类使用率提升至66.1%（39/59）。基线时，甲状腺超声报告总体诊断符合率为80.6%±11.7%，二级医院的超声诊断符合率高于一级医院[（88.8%±9.4%） vs （78.8%±11.5%）]，差异具有统计学意义（t=3.064，P=0.007）；培训后，甲状腺超声报告总体诊断符合率为83.5%±7.6%，二级医院的超声诊断符合率高于一级医院[（88.9%±6.5%） vs （82.2%±7.4%）]，且一级医院的超声诊断符合率较基线时有了显著提高，差异均具有统计学意义（t=2.987，P=0.009；t=-2.453，P=0.018）。

结论

北京市海淀区超声质控中心通过开展甲状腺规范化扫查及C-TIRADS 分类推广工作，提高了辖区内二级和一级医院C-TIRADS 分类使用率，并显著提升了一级医院甲状腺结节超声诊断符合率，有利于分级诊疗格局的建立和完善。

Objective

To explore the role of promotion of standardized thyroid ultrasound examination and C-TIRADS classification in improving the diagnostic concordance rate of thyroid ultrasound examinations in secondary and primary healthcare institutions in Haidian District, Beijing.

Methods

From July 2023 to June 2024, the Ultrasound Medical Quality Control and Improvement Center of Haidian District, Beijing conducted a one-year program of training and promotion of standardized thyroid ultrasound examination and C-TIRADS classification among secondary and primary healthcare institutions in Haidian District, Beijing.Both at baseline and after training, an online questionnaire survey was used to investigate the usage of C-TIRADS classification and the diagnostic concordance rate of thyroid ultrasound examinations in the involved institutions.The t-test was employed to compare the differences in diagnostic concordance rates between secondary and primary hospitals, as well as before and after training.

Results

A total of 59 valid questionnaires were finally included.At baseline, the usage rate of C-TIRADS classification was 30.5% (18/59); after training, it increased to 66.1% (39/59).At baseline, the overall diagnostic concordance rate of thyroid ultrasound examinations was 80.6%±11.7%.The diagnostic concordance rate in secondary hospitals was significantly higher than that in primary hospitals [(88.8%±9.4%) vs (78.8%±11.5%),t=3.064, P=0.007].After training, the overall diagnostic concordance rate of thyroid ultrasound examinations was 83.5%±7.6%.The diagnostic concordance rate in secondary hospitals remained significantly higher than that in primary hospitals [(88.9%±6.5%) vs (82.2%±7.4%), t=2.987, P=0.009], and the concordance rate in primary hospitals significantly increased compared with the baseline level (t=-2.453, P=0.018).

Conclusion

The Ultrasound Medical Quality Control and Improvement Center of Haidian District, Beijing has successfully increased the usage rate of C-TIRADS classification for thyroid nodules in secondary and primary hospitals in Haidian District, Beijing, significantly improving the diagnostic concordance rate of thyroid nodule ultrasound in primary hospitals.These efforts are beneficial for the establishment of a tiered diagnosis and treatment pattern.