Parts S.A., Reshetov I.V., Kuzmina E.S., Semenova A.B., Tarakanova O.V., Shatalov V.G., Sabitov E.R., Horuzhaya S.S., Mulyarets M.V., Vyzhigina B.B., Ganina Ch.A. The role of multimodal organization of out
DOI: https://doi.org/10.25792/HN.2024.12.4.50-58
Background. Malignant tumors of the thyroid gland represent a significant problem in oncology due to the high prevalence and difficulty of diagnosis at the outpatient stage, requiring the efforts of a multidisciplinary team – oncologist, cytologist, ultrasound diagnostics specialist. Purpose of the study. To improve diagnostics of thyroid cancer by reducing the examination time and increasing the informativeness of cytological diagnostics of thyroid tumors with multimodal approach. Material and methods. We analyzed the routing system for patients with suspected thyroid cancer in the Federal Budgetary Healthcare Institution Moscow City Oncological Hospital No.1, Moscow Healthcare Department, identified the risks and proposed a modified routing scheme. A comparative assessment of the examination time and the proportion of non-diagnostic fine needle aspirations according to the BETHESDA classification was used to assess the efficiency of the suggested transformations. Results. We established that the examination of patients with suspected thyroid cancer requires the participation of a number of specialists: oncologist, cytologist, and ultrasound diagnostics specialist, which carries the risk of disruption of continuity between the specialists, increased time and incorrect interpretation of clinical and instrumental data. A modified routing scheme based on the principle of multimodal outpatient admission is considered. We found that such organization of outpatient care in the diagnostics of thyroid cancer allows to reduce the examination period by 12.5–16.7%. The results of cytological assessments of 2354 patients with suspected thyroid cancer were studied, and a statistically significant increase in the informativeness of preoperative examination was noted with fewer non-diagnostic fine needle aspirations and an increase in informative aspirations. Conclusion: The presented multimodal system of the outpatient medical care organization for malignant tumors of the thyroid reduces the risk of exceeding the term of examination and allows to increase the informativeness of cytological diagnostics. Keywords: oncology multidisciplinary team, thyroid cancer, EU-TIRADS, fine needle aspiration, BETHESDA categories, multimodal assessment Conflicts of interest. The authors have no conflicts of interest to declare. Funding. There was no funding for this study