Comparison of Modified Rose Method of Thyroid Palpation versus other Methods for the Detection of Retrosternal and Nodular Goitre

  • Santosha Kumar Pattashanee All India Institute of Medical Sciences, New Delhi, India https://orcid.org/0000-0003-1208-1349
  • Gopal Puri All India Institute of Medical Sciences, New Delhi, India https://orcid.org/0000-0002-4328-1100
  • Kamal Kataria All India Institute of Medical Sciences, New Delhi, India https://orcid.org/0000-0003-2200-7652
  • Piyush Ranjan All India Institute of Medical Sciences, New Delhi, India https://orcid.org/0000-0002-8975-2449
  • Anita Dhar All India Institute of Medical Sciences, New Delhi, India
  • Anurag Srivastava All India Institute of Medical Sciences, New Delhi, India
  • Surabhi Vyas All India Institute of Medical Sciences, New Delhi, India
  • Yashdeep Gupta All India Institute of Medical Sciences, New Delhi, India https://orcid.org/0000-0002-4345-717X
  • RM Pandey All India Institute of Medical Sciences, New Delhi, India
Keywords: Retro-sternal extension, Kappa statistic, modified rose method, Modified Rose position,, Clinical thyroid examination

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 eighty-three 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.

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Author Biographies

Santosha Kumar Pattashanee, All India Institute of Medical Sciences, New Delhi, India

Department of Surgical Disciplines

Gopal Puri, All India Institute of Medical Sciences, New Delhi, India

Department of Surgical Disciplines

Kamal Kataria, All India Institute of Medical Sciences, New Delhi, India

Department of Surgical Disciplines

Piyush Ranjan, All India Institute of Medical Sciences, New Delhi, India

Department of Surgical Disciplines

Anita Dhar, All India Institute of Medical Sciences, New Delhi, India

Department of Surgical Disciplines

Anurag Srivastava, All India Institute of Medical Sciences, New Delhi, India

Retired Professor and Head, Department of Surgical Disciplines

Surabhi Vyas, All India Institute of Medical Sciences, New Delhi, India

Department of Radiology

Yashdeep Gupta, All India Institute of Medical Sciences, New Delhi, India

Department of Endocrinology

RM Pandey, All India Institute of Medical Sciences, New Delhi, India

Department of Biostatistics

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Published
2022-02-16
How to Cite
Pattashanee, S. K., Puri, G., Kataria, K., Ranjan, P., Dhar, A., Srivastava, A., Vyas, S., Gupta, Y., & Pandey, R. (2022). Comparison of Modified Rose Method of Thyroid Palpation versus other Methods for the Detection of Retrosternal and Nodular Goitre. JAFES , 37(1). Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/1185
Section
Original Articles