The ATA guidelines taskforce used a strategy similar to that used by the National Institutes of Health for its Consensus Development Conferences (www.consensus.nih.gov/about/process.htm), and developed a series of clinically relevant questions pertaining to thyroid nodule and thyroid cancer diagnosis and treatment. These questions were as follows:
A 2-day meeting of the taskforce was held on January 21–23, 2005. Prior to the meeting, the taskforce members undertook a complete literature review. Relevant articles were identified by searching MEDLINE using the following search terms: {THRYOID NODULE/diagnosis, drug therapy, surgery, therapy, ultrasonography} or {CANCER} or {CARCINOMA} and {THYROID} and {FOLLICULAR CARCINOMA} or {PAPILLARY CACINOMA} and {FOLLOW-UP} and {TREATMENT} and {RECURRENCE}. All Englishlanguage papers published between 1995 and December 2004 were reviewed and categorized in tabular form by date, author, subject, and whether it represented a randomized controlled trial, meta-analysis, or clinical case series. Relevant review articles, book chapters, and pre-1995 articles were also supplied by taskforce members. The taskforce categorized the published data using modified criteria adopted from the U.S. Preventive Services Task Force (USPSTF) (13). The taskforce then made specific recommendations, rated the strength of the recommendation using the schema proposed by the USPSTF (Table 1). Given the paucity of randomized controlled trials in the treatment of thyroid cancer, the panel relied on all the available published evidence. When evidence was judged to be insufficient, the taskforce members also relied on their experience and judgment to answer the questions that had been posed. The taskforce met again in April 2005 and in June 2005 to refine the document and include new references. Supplementing these meetings were multiple teleconferences and detailed e-mail communications that continued through July 2005.
