Impact of Triple Assessment on Surgical Decision-making in Thyroid Nodule Management

Abstract Introduction: Accurate preoperative assessment of thyroid nodules is crucial for distinguishing malignant from benign lesions and making optimal decisions. Triple assessment using clinical examination, ultrasonography (USG), and fine needle aspiration cytology (FNAC) has been increasingly used to improve diagnostic accuracy. Aim: The aim of the study was to evaluate the efficacy of triple assessment in the detection and treatment of thyroid nodules by correlating ultrasonographic findings, clinical evaluation, and FNAC results with histopathological diagnosis. Methods: This study was a prospective observational study of 56 patients with thyroid nodules undergoing surgical management. Data were collected prospectively using structured case record forms. Baseline information, physical examination findings, USG features, FNAC records, operative details, and histopathological reports were documented. Data were analyzed using descriptive statistics. Frequency and percentage were used to present categorical variables. The diagnostic accuracy of clinical examination, USG, FNAC, and triple assessment was evaluated by estimating specificity, sensitivity, negative predictive value (NPV), positive predictive value, and diagnostic accuracy. Results: A higher proportion of participants were female (85.7%) and were in the 41–60 years old age group. Histopathology confirmed benign lesions in 57.14% and malignant lesions in 42.86% of cases. Triple assessment achieved the most effective diagnostic accuracy, showing a sensitivity of 100%, a specificity of 87.50%, with a NPV of 100% and an overall diagnostic accuracy of 97.86%. Conclusion: Triple assessment is a dependable and useful modality for assessing thyroid nodules. Combined use of clinical examination, USG, and FNAC reduces false-negative results and supports appropriate clinical decision-making.