{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:27:54Z","timestamp":1787304474493,"version":"build-2736575974"},"reference-count":4,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National institute of health","award":["R37CA272473"],"award-info":[{"award-number":["R37CA272473"]}]},{"name":"National cancer institute","award":["P30CA134274"],"award-info":[{"award-number":["P30CA134274"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Endocrine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Increasing use of thyroid ultrasound has contributed to the overdiagnosis of low-risk thyroid cancer which has in turn led to overtreatment as well. Despite established guidelines, deviations from evidence-based use persist. We evaluated clinician-reported practices, knowledge, and perceptions regarding thyroid ultrasound ordering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a pilot, exploratory, cross-sectional survey of clinicians at the University of Maryland Medical System. A 21-item electronic questionnaire assessed guideline familiarity, ordering practices, and perceived drivers of thyroid ultrasound use. The survey was distributed to internal medicine, family medicine, and endocrinology trainees, advanced practice providers, and faculty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty clinicians responded (43% internal medicine (IM), 40% endocrinology, 13% family medicine (FM), 3% IM and FM). One-third reported ordering 1\u20135 thyroid ultrasounds annually, while 20% reported ordering more than 50. Although 50% believed diagnostic testing improves outcomes, 47% perceived thyroid ultrasound as overused. Ordering was most driven by physical exam findings, compressive symptoms, and incidental nodules, rather than demographic factors or screening. Familiarity with American Thyroid Association guidelines exceeded that of American College of Radiology guidelines. Only 62% reported confidence in their own knowledge regarding thyroid ultrasound ordering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinicians recognize potential overuse of thyroid ultrasound, driven by multi-factorial influences. Gaps in familiarity and confidence may contribute to practice variation, highlighting opportunities for targeted interventions to promote high-value care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12020-026-04742-0","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:06:40Z","timestamp":1787303200000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Variation and potential overuse in thyroid ultrasound ordering: exploratory insights from a clinician survey"],"prefix":"10.1007","volume":"91","author":[{"given":"Sualeha","family":"Khalid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria","family":"Ratzki-Leewing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan P.","family":"Brito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naykky Singh","family":"Ospina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2289-3183","authenticated-orcid":false,"given":"Rozalina G.","family":"McCoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"issue":"12","key":"4742_CR1","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1016\/j.eprac.2023.09.006","volume":"29","author":"C Soto Jacome","year":"2023","unstructured":"C. Soto Jacome, D. Segura Torres, J.W. Fan et al., Drivers of Thyroid Ultrasound Use: A Retrospective Observational Study. Endocr. Pract. 29(12), 948\u2013954 (2023). https:\/\/doi.org\/10.1016\/j.eprac.2023.09.006","journal-title":"Endocr. Pract."},{"issue":"2","key":"4742_CR2","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1007\/s12020-016-1054-y","volume":"54","author":"N Singh Ospina","year":"2016","unstructured":"N. Singh Ospina, S. Maraka, A.E. De Espinosa et al., Physical exam in asymptomatic people drivers the detection of thyroid nodules undergoing ultrasound guided fine needle aspiration biopsy. Endocrine 2016\/11\/01. 54(2), 433\u2013439 (2016). https:\/\/doi.org\/10.1007\/s12020-016-1054-y","journal-title":"Endocrine 2016\/11\/01"},{"issue":"2","key":"4742_CR3","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s12020-021-02820-z","volume":"74","author":"MK Edwards","year":"2021","unstructured":"M.K. Edwards, N.M. I\u00f1iguez-Ariza, N. Singh Ospina, E. Lincango-Naranjo, S. Maraka, J.P. Brito, Inappropriate use of thyroid ultrasound: a systematic review and meta-analysis. Endocrine Nov. 74(2), 263\u2013269 (2021). https:\/\/doi.org\/10.1007\/s12020-021-02820-z","journal-title":"Endocrine Nov"},{"issue":"10","key":"4742_CR4","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1001\/jamasurg.2020.2507","volume":"155","author":"DW Chen","year":"2020","unstructured":"D.W. Chen, D. Reyes-Gastelum, A. Radhakrishnan, A.S. Hamilton, K.C. Ward, M.R. Haymart, Physician-Reported Misuse of Thyroid Ultrasonography. JAMA Surg. 155(10), 984\u2013986 (2020). https:\/\/doi.org\/10.1001\/jamasurg.2020.2507","journal-title":"JAMA Surg."}],"container-title":["Endocrine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12020-026-04742-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12020-026-04742-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12020-026-04742-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:06:41Z","timestamp":1787303201000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12020-026-04742-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":4,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4742"],"URL":"https:\/\/doi.org\/10.1007\/s12020-026-04742-0","relation":{},"ISSN":["1559-0100"],"issn-type":[{"value":"1559-0100","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"assertion":[{"value":"20 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"In the last 36 months, Dr. Ratzki-Leewing has received unrelated research support from Sanofi Global, and the National Institute on Aging (NIA). She has consulted for Dexcom Canada, Abbott Canada, Sanofi US, and Sanofi Global; served on advisory boards for Sanofi US; and received speaking honoraria from Sanofi Global, Sanofi Canada, Dexcom Canada, Abbott Canada, and the American Diabetes Association. In the last 36 months, Dr. McCoy has served as a consultant to the Yale-New Haven Health System\u2019s Center for Outcomes Research and Evaluation and has received speaking honoraria and travel support from the American Diabetes Association. Other authors have no conflicts of interest to disclose. Drs. Khalid, Brito and Singh Ospina did not report any conflict of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.","order":2,"name":"Ethics","label":"Disclaimer","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"IRB Protocol #HP-00109924 received exemption from University of Maryland School Medicine IRB. All participants were contacted via email and participation was voluntary. Human ethics and consents not applicable.","order":3,"name":"Ethics","label":"IRB status","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"283"}}