Comparison of Modified Rose Method of Thyroid Palpation versus other Methods for the Detection of Retrosternal and Nodular Goitre
https://doi.org/10.15605/jafes.037.01.02
- Author:
Santosha Kumar Pattashanee
1
;
Gopal Puri
1
;
Kamal Kataria
1
;
Piyush Ranjan
1
;
Anita Dhar
1
;
Anurag Srivastava
1
;
Surabhi Vyas
2
;
Yashdeep Gupta
3
;
RM Pandey
4
Author Information
1. Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
2. Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
3. Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
4. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
- Publication Type:Journal Article
- Keywords:
Clinical thyroid examination;
Modified Rose position;
Modified Rose method;
Kappa statistic;
Retro-sternal extension
- From:
Journal of the ASEAN Federation of Endocrine Societies
2022;37(1):4-13
- CountryPhilippines
- Language:English
-
Abstract:
Objectives:This is a diagnostic test research study to evaluate the various existing methods of thyroid examination and their comparison with the novel modified Rose method. It also aims to measure inter-examiner variation in clinical findings based on the level of education and training, as compared to ultrasonography.
Methodology:This cross-sectional study was conducted at a tertiary care hospital with 83 patients presenting to surgery OPD with neck swelling. Each patient was examined by one trained Junior Resident and a Surgery Consultant with all the four methods and with ultrasonography. Data was analysed by Stata-14, agreement between the two categorical variables was assessed by Kappa. In case of continuous variable agreement was assessed by Intra class correlation and Bland-Altman plot.
Results:Modified Rose method by the consultant has the highest sensitivity (98%) and diagnostic odds (210) as compared to others but its specificity ranges from 46.7-91.1% to diagnose retro-sternal extension of a goiter. It has 93.98% agreement for identification of nodules. It has a high specificity (Consultant - 100%, Resident - 95.5%) with relatively lower sensitivity (Consultant - 94%, Resident - 86.8%) to diagnose solitary thyroid nodule (STN) but the sensitivity and specificity for diagnosing a multinodular goitre (MNG) was high. However, the highest sensitivity to diagnose STN was highest with Crile’s method, but specificity was low. Lahey’s method was a better clinical method to palpate lymph nodes compared to the other three.
Conclusion:Examination in modified Rose’s position is a better method of clinical examination of thyroid especially in patients with occult substernal extension. Lahey’s method is a better method to examine cervical lymph nodes.
- Full text:1185-Article Text-17201-3-10-20220529.pdf
