The Choosing Wisely RI campaign promotes productive conversations between patients and doctor--conversations that research shows produce the right level of care and go a long way towards eliminating tests, procedures and medications that provide, little, if any benefit. The campaign is organized and promoted by the Rhode Island Business Group on Health (RIBGH) and draws on the expertise of the American Board of Internal Medicine Foundation. While we provide materials that enable patients to have informed conversations with their doctors and other health care providers, we do not provide any individual medical advice.
Choosing Wisely provides employees free-of-charge access to online tools developed by ABIMF and their 80+ Specialty Society partners.
The Choosing Wisely Mobile Phone App for Apple and Android phones gives employees the chance to view the Choosing Wisely materials and recommendations on their phones - possibly when they are in their physician's office!
Get daily updates from Choosing Wisely RI on our Facebook page!
Join the more than 40 organizations who have already adopted Choosing Wisely. Launching the campaign for Your Employees is Easy!
Recommendations on Ultrasounds for Thyroid Nodules
January is Thyroid Health Awareness Month. In honor of this observance, we have included Choosing Wisely’s recommendations for thyroid nodule ultrasounds from The American College of Radiology.
The American College of Radiology does not recommend ultrasounds for incidental thyroid nodules found on CT, MRI, or non-thyroid-focused neck ultrasounds in low-risk patients unless the nodule meets age-based size criteria or has suspicious features.
According to The American College of Radiology, imaging of the neck performed to evaluate non-thyroid-related conditions commonly reveals thyroid nodules, most of which are malignant. However, even malignant nodules are likely to have indolent behavior.
According to The American College of Radiology, some patients with incidentally-discovered benign nodules undergo unnecessary serial ultrasound imaging and/or surgery because certain procedures often fail to definitively characterize a lesion as benign. The American College of Radiology recommends that patients without clinical risk factors who are found to have asymptomatic, incidental, non suspicious thyroid nodules on imaging tests should be referred for a diagnostic thyroid ultrasound only if they meet the following criteria:
1) < 35 years of age with normal life expectancy and nodule ≥ 1 cm.
Two published studies reported that the percentage of nodules referred for ultrasound would be reduced by 35–46% by referring patients for ultrasounds only if:
1) Suspicious features on CT, MRI or US include signs of local invasion, and the presence of abnormal lymph nodes.