{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:41:39Z","timestamp":1761007299428,"version":"build-2065373602"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The incidence of pediatric thyroid cancer has increased. Little is documented about which providers are diagnosing pediatric thyroid nodules and how this impacts care. Our objective was to analyze how nodules are identified and how diagnosing provider type impacts nodule size and management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care children's hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pediatric patients (aged 0\u201017) with at least one thyroid nodule diagnosed between 2006 and 2023 were reviewed. Diagnosing provider type, diagnostic method, nodule size, clinical management, and final diagnosis were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 351 patients. Primary care providers diagnosed the largest proportion of nodules (43.0%), followed by incidental nodules by radiologists (24.2%). The proportion diagnosed by radiologists increased from 12% to 31% after 2017 (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Primary care providers were more likely to use physical exam than pediatric endocrinologists (65% vs 42%, <jats:italic>P<\/jats:italic>\u2009=\u2009.004), who more often used ultrasound (56% vs 37%, <jats:italic>P<\/jats:italic>\u2009=\u2009.02). Primary care providers diagnosed nodules with a median diameter of 1.50\u2009cm, larger than that of pediatric endocrinologists and radiologists, both 0.8\u2009cm (<jats:italic>P<\/jats:italic>\u2009=\u2009.01, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Compared to patients diagnosed by radiologists, patients diagnosed by primary care providers more often underwent biopsy (<jats:italic>P<\/jats:italic>\u2009=\u2009.02) or surgery (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and received a malignant diagnosis (<jats:italic>P<\/jats:italic>\u2009=\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Primary care providers play a key role in detecting pediatric thyroid nodules, and a physical exam is vital in identifying significant pathology. Radiologic incidental nodules increased in frequency over our study timespan. Future research should consider the impact of socioeconomic status or geographic location on nodule size and management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1232","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T09:59:31Z","timestamp":1742378371000},"page":"251-259","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Who Is Diagnosing Pediatric Thyroid Nodules? A Tertiary Children's Hospital Review"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8984-1249","authenticated-orcid":false,"given":"Joy M.","family":"Justice","sequence":"first","affiliation":[{"name":"Vanderbilt University School of Medicine Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janavi","family":"Sethurathnam","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanda","family":"Nayak","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi","family":"Chen","sequence":"additional","affiliation":[{"name":"Vanderbilt University Department of Biostatistics Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalpnaben","family":"Patel","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Center for Kids (SOCKS) Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Bartz","sequence":"additional","affiliation":[{"name":"Vanderbilt University Department of Pediatrics Division of Pediatric Endocrinology and Diabetes Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Baron","sequence":"additional","affiliation":[{"name":"Vanderbilt University Department of Radiology Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barron","family":"Patterson","sequence":"additional","affiliation":[{"name":"Vanderbilt University Department of Pediatrics Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9490-3694","authenticated-orcid":false,"given":"Ryan H.","family":"Belcher","sequence":"additional","affiliation":[{"name":"Vanderbilt University Department of Otolaryngology\u2013Head and Neck Surgery Nashville Tennessee USA"},{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Monroe Carell Jr. Children's Hospital at Vanderbilt Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.16257"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2018.0728"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1796"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2017170059"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2473974X211073702"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnad022"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1677\/erc.1.00882"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2011.09.023"},{"issue":"1","key":"e_1_2_8_10_1","first-page":"57","article-title":"Thyroid nodules in pediatrics: which ones can be left alone, which ones must be investigated, when and how","volume":"4","author":"Corrias A","year":"2012","journal-title":"J Clin Res Pediatr Endocrinol"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.13414"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28141"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32125"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2022.101715"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2022.11.030"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018171170"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2010.114"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.06.011"},{"issue":"157","key":"e_1_2_8_19_1","first-page":"1","article-title":"New census reflects growing U.S. population diversity, with children in the forefront","volume":"441","author":"Johnson KM","year":"2021","journal-title":"Carsey School Public Policy"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-0188"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.33710"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2022.111331"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2021.0692"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9020384"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2013.10.090"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1604412"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f4706"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32424"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1159\/000503323"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2013.0257"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-018-4281-y"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2010.270"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.2209"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.14.13895"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.162.6.526"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00565"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1159\/000443143"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2022-0334"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.1232","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:24:11Z","timestamp":1760963051000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.1232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,19]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/ohn.1232"],"URL":"https:\/\/doi.org\/10.1002\/ohn.1232","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"type":"print","value":"0194-5998"},{"type":"electronic","value":"1097-6817"}],"subject":[],"published":{"date-parts":[[2025,3,19]]},"assertion":[{"value":"2024-12-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}