347 PEDIATRIC FINE-NEEDLE ASPIRATION CYTOLOGY: A SYSTEMATIC REVIEW.
Notice bibliographique
Résumé
Thyroid nodules are relatively rare in the pediatric population compared with the adult population, affecting 1.6 to 1.8% of children and adolescents. However, the risk of malignancy at presentation is much higher and the presentation of a patient with a thyroid nodule in pediatrics represents a diagnostic challenge for physicians as management decisions often depend on whether a nodule is malignant or benign. As part of the clinical workup for thyroid nodules, a variety of diagnostic studies are indicated to detect or dismiss malignancy, including thyroid function tests (eg, T3 and T4, TSH, and thyroid antibodies), radioiodine scanning, ultrasound imaging, and fine-needle aspiration biopsy. Of the available preoperative diagnostic tools, fine-needle aspiration cytology (FNAC) seems to be the most accurate tool in the diagnosis of a thyroid nodule. In adults, FNAC has been established in large reviews as a useful test in the differentiation of a thyroid nodule as malignant or benign. As a result, FNAC has significantly reduced the number of surgeries for nodules preoperatively diagnosed as benign. Due to the higher risk of malignancy in pediatric thyroid nodules, it is common practice in many institutions to remove surgically any with FNAC playing a limited role in the treatment algorithm. This is partly because of the lack of consensus and available literature regarding the utility of FNAC of thyroid nodules in the pediatric population. Many research groups have found that FNAC in children and adolescents is a highly sensitive and accurate test in differentiating benign from malignant nodules. Of these, most groups have also suggested that FNAC can reduce the need for surgery for those with benign cytology results. However, other studies have shown the opposite: that FNAC in pediatrics is not as accurate as physicians had hoped for and that surgery and subsequent pathology diagnosis are still required to rule out a malignant thyroid nodule. This study is a systematic review of all available studies that look at the diagnostic value of fine-needle aspiration biopsy of the thyroid in the pediatric population. Studies that looked at sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were included. Finally, the studies were analyzed for quality according to items on the QUADAS quality checklist for diagnostic studies developed by Whiting et al.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».