BACKGROUND: @entity400 ( @entity400 ) is an accurate test commonly used to determine whether thyroid nodules are malignant in adults. However, less is known about its diagnostic accuracy for this purpose in @entity1 , where conduct of @entity400 is less frequent, more technically challenging, and pre-test probabilities of @entity5 are often higher. The purpose of this systematic review is to evaluate the diagnostic accuracy of @entity400 for the detection of @entity5 in pediatric thyroid nodules. METHODS: We will search electronic bibliographic databases (MEDLINE, EMBASE, the Cochrane Library, and Evidence-Based Medicine) from their date of inception, reference lists of included articles, proceedings from relevant conferences, and the table of contents of the Journal of Pediatric Surgery (January 2007-present). Two reviewers will independently screen titles and abstracts and identify diagnostic accuracy studies involving @entity400 of the thyroid in @entity1 . We will include studies comparing @entity400 to a reference standard of surgical histopathology or clinical follow-up for detection of @entity5 in pediatric thyroid nodules. Two investigators will independently extract data and assess risk of bias using the Quality of Diagnostic Accuracy Studies-II tool. Pooled estimates of sensitivity, specificity, and positive and negative likelihood ratios will be calculated using bivariate random-effects and hierarchical summary receiver operating characteristic models. In the presence of between-study heterogeneity, we will conduct stratified meta-analyses and meta-regression to determine whether diagnostic accuracy estimates vary by country of origin, use of ultrasound guidance during @entity400 , qualifications of the individuals performing/interpreting @entity400 , adherence to the Bethesda criteria for cytology classification, length of clinical follow-up, timing of data collection, @entity1 selection methods, and presence of verification bias. DISCUSSION: This meta-analysis will determine the diagnostic accuracy of @entity400 for detection of @entity5 in pediatric thyroid nodules and explore whether heterogeneity observed across studies may be explained by variations in @entity1 population, @entity400 technique or interpretation, and/or study-level risks of bias. This will be the first study to determine the accuracy of Bethesda cytological classification levels of @entity400 (benign, atypical, follicular, suspicious, malignant). We expect that our results  will help in guiding clinical decision-making in @entity1 with thyroid nodules. SYSTEMATIC REVIEW REGISTRATION: PROSPERO No. CRD42014007140.

Diagnostic accuracy of fine needle aspiration biopsy for detection of XXXX in pediatric thyroid nodules: protocol for a systematic review and meta-analysis.

@entity1 :: ('9606', 'Species') :: ['children', 'patient'] @entity400 :: ('MESH:D014202', 'Disease') :: ['Fine needle aspiration biopsy', 'FNAB'] @entity5 :: ('MESH:D009369', 'Disease') :: ['malignancy']
@entity5 :: (MESH:D009369,Disease) :: ['malignancy']
