Abstract:

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.

Key words: Thyroid, Ultrasound, Thyroid imaging reporting and data system, Diagnostic concordance rate, Primary medical institutions