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Good Positive and Negative Likelihood Ratios

Good Positive Likelihood Ratio

Poorly Diagnostic Findings

Thyroid Carcinoma: Likelihood Ratios

Introduction: Note that some of the findings below are listed for nodules and others for actual cancer.

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Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Thyroid nodules in the general population	67%	by ultrasound Arch Intern Med. 1994 Aug 22;154(16):1838-40. PMID: 8053752
Carcinoma in thyroid nodules	5%	note: in this study there was a huge difference in malignancy risk based on nodules discovered incidentally on ultrasound (17%) versus ultrasound studies done for non-incidental reasons (3%) J Ultrasound Med. 2005 May;24(5):629-34. PMID: 15840794
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The likelihood ratios of findings for Thyroid Carcinoma are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] FNA	+ 0 -	9.4	0.4
for carcinoma as diagnosed by thyroidectomy note that this sensitivity (and specificity) is an estimate since only 25% of FNA negative patients got thyroidectomy Study: Ann Surg. 2007 Nov;246(5):714-20. PMID: 17968160

Good Positive Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] Palpation	+ 0 -	inf	0.7
for a nodule or nodules, compared to ultrasound Study: Arch Intern Med. 1994 Aug 22;154(16):1838-40. PMID: 8053752

Poorly Diagnostic Findings
Finding	Result	+LR	-LR
[ + ] Solitary Nodule	+ 0 -	1.4	0.7
by ultrasound, for a diagnosis of carcinoma Study: Surgery. 2007 Dec;142(6):851-7. PMID: 18063067