Implementation of a Standardized Thyroid USG Reporting and D
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This JAMA study suggests that a comprehensive thyroid ultrasonography documentation system that includes a standardized reporting form can substantially improve clinic-wide documentation of thyroid nodule characteristics.

The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) is commonly used to assess the malignant neoplasm risk potential of thyroid nodules imaged by ultrasonography. This study is aimed to increase the documentation rate of ACR TI-RADS thyroid nodule characteristics to 80% in 18 months.

This prospective interrupted time series quality improvement study was conducted among 229 patients who had at least 1 documented thyroid nodule identified on bedside clinic ultrasonography. Data analysis was performed throughout the entire study period because this was a quality improvement study with iterative small cycle changes.

--The size was the most frequently documented nodule characteristic at baseline, followed by echogenic foci, composition, echogenicity, margin, and shape.

--After 3 Plan, Do, Study, Act (PDSA) cycles, the final intervention consisted of a standardized USG reporting form and educational initiatives for surgical trainees.

-- After the third PDSA cycle, reporting of nodule size, echogenic foci, and composition increased to 100%. Similarly, reporting of echogenicity, shape, and margin all increased.

--This represented a cumulative 90.3% documentation rate, a 56.5% increase from baseline. The standardized reporting form was used in 83.3% of eligible thyroid ultrasonography cases after PDSA cycle 3, demonstrating good fidelity of implementation.

This study suggests that implementation of an ACR TI-RADS–based reporting form in conjunction with educational initiatives improved documentation of ultrasonographic thyroid nodule characteristics, potentially allowing for improved bedside risk stratification and communication among clinicians.