3.An audit study of the sensitivity and specificity of ultrasound, fine needle aspiration cytology and frozen section in the evaluation of thyroid malignancies in a tertiary institution.
Winson J H TAN ; Kaushal SANGHVI ; Kui Hin LIAU ; Cheng Hock LOW
Annals of the Academy of Medicine, Singapore 2010;39(5):359-362
INTRODUCTIONThe aim of this study was to conduct an audit of the sensitivity and specificity of ultrasound, fi ne needle aspiration cytology (FNAC) and frozen section in the evaluation of thyroid malignancies in our practice.
MATERIALS AND METHODSThe medical records of all the patients who underwent thyroid surgery in a tertiary institution's General Surgery Department between January 2005 and December 2007 were retrospectively reviewed using a standardised data collection template. Results of the ultrasounds, FNACs and frozen sections were compared with the fi nal histological diagnosis.
RESULTSA total of 112 patients underwent thyroid surgery in the 3-year study period. Thyroid malignancy constituted 34 (30%) of all patients who underwent thyroid surgery. The most popular diagnostic tools used were ultrasound (81%), FNAC (69%) and frozen section (59%). The sensitivity of ultrasound, FNAC and frozen section were 41.4%, 86.4% and 68.8%, respectively. FNAC was shown to be a superior diagnostic test in detecting malignancy compared to ultrasound. FNAC was able to pick up 53% of thyroid cancers missed by ultrasound. Frozen section was able to pick up 33% of thyroid cancers that were missed by both ultrasound and FNAC.
CONCLUSIONFNAC is the most reliable tool in detecting malignancies and ought to form the mainstay for investigation of thyroid nodules. The utilisation of ultrasonographic features in the evaluation of thyroid nodules might not necessary improve the detection rate of thyroid malignancy. Frozen section helps to improve the detection rate of thyroid malignancy but further studies into its cost-effectiveness ought to be performed.
Adult ; Biopsy, Fine-Needle ; Female ; Frozen Sections ; Humans ; Male ; Medical Audit ; Middle Aged ; Sensitivity and Specificity ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; Ultrasonography
4.Academy of Medicine-Ministry of Health clinical practice guidelines: attention deficit hyperactivity disorder.
Daniel S S FUNG ; Choon Guan LIM ; John Chee Meng WONG ; Koon Hock NG ; Christopher Cheng Soon CHEOK ; Jennifer Sie Hee KIING ; Shang Chee CHONG ; June LOU ; Mary Lourdes DANIEL ; Desmond ONG ; Charity LOW ; Sharifah Mariam ALJUNIED ; Pui Meng CHOI ; Kala MEHROTRA ; Carolyn KEE ; Ivy LEUNG ; Lee Chen YEN ; Geraldine WONG ; Poh Yin LEE ; Bella CHIN ; Hwee Chien NG
Singapore medical journal 2014;55(8):411-quiz 415
The Academy of Medicine (AMS) and the Ministry of Health (MOH) have developed the clinical practice guidelines on Attention Deficit Hyperactivity Disorder (ADHD) to provide doctors and patients in Singapore with evidence-based treatment for ADHD. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on ADHD, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html.The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
Attention Deficit Disorder with Hyperactivity
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diagnosis
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drug therapy
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therapy
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Caregivers
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Child
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Evidence-Based Medicine
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Humans
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Methylphenidate
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therapeutic use
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Parents
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Psychiatry
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methods
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standards
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Singapore
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Societies, Medical
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