MON-394 Indications and Outcomes of Thyroid Ultrasounds Obtained at Primary Care Clinics within a Large Health System

Abstract Disclosure: K.M. Bakhtawar: None. A. Dharia: None. G. Jaiswal: None. Introduction: Thyroid ultrasounds are considered the gold standard for evaluating and monitoring thyroid nodules. From 2002 to 2013, the frequency of thyroid ultrasounds increased by 21%, which parallels the rise in thyroid cancer diagnoses. A meta-analysis of 7 studies involving 1,573 patients (1998-2019) found that 10-46% of thyroid ultrasounds were ordered without appropriate clinical guidelines, with the most common being thyroid dysfunction (17%) and non-specific symptoms without a palpable mass (11%). A survey of 610 physicians revealed that one-third of the orders were made at the patient's request. Furthermore, patients diagnosed with thyroid cancer are at higher risk of bankruptcy due to financial burdens. These factors highlight the need for further studies on the implications of the overuse of thyroid ultrasounds. Study Aim: The primary goal of the study is to assess whether thyroid ultrasounds are being ordered for appropriate indications. The study seeks to determine the proportion of thyroid ultrasounds that are not in line with clinical guidelines, assess the downstream clinical consequences of such orders, and estimate the associated costs to both patients and the healthcare system. Methods: Medical record numbers of patients with thyroid ultrasounds ordered by primary care physicians at Allegheny Health Network between January 1, 2018, and December 31, 2019, were extracted. Diagnosis codes linked to the ultrasound orders were identified, and chart reviews were conducted to determine the reasons behind the imaging studies. The ultrasound results and subsequent follow-up workup were noted. Medicare reimbursement data was used to estimate the overall cost of ultrasounds that did not align with clinical guidelines. The inclusion criteria focused on patients aged 18-65 who had their first thyroid ultrasound during this period, excluding those with prior thyroid ultrasounds, history of cancers (other than thyroid or parathyroid), transplants, or pregnancy. Results and Discussion: A total of 1,526 patient charts were retrieved and 1,000 charts were reviewed in detail. Our preliminary data demonstrated that around 30% of the ultrasounds did not meet guideline-based indications. Data analysis is still ongoing and the results will be available for presentation at the conference. This study will provide insights into the appropriateness of thyroid ultrasound utilization to optimize resource allocation and minimize unnecessary costs in the healthcare system. Presentation: Monday, July 14, 2025