Does color Doppler ultrasound has high value in the diagnosis of thyroid nodules?

We read the recent published paper in this journal of Gland Surgery by Zhao and colleagues entitled “The value of color Doppler ultrasound in the diagnosis of thyroid nodules: a systematic review and meta-analysis” (1). They performed a systematic review and meta-analysis to analyze the value of color Doppler ultrasound in the diagnosis of thyroid nodules. We appreciate Zhao et al. (1) for the valuable study, however, after a careful learning of the literature, several limitations should be noticed.

First, in the methods section of the abstract, the authors depicted that the Jadad tool was utilized to assess the quality of the included articles. However, the risk of bias and methodological quality of the included studies were actually evaluated by using the Quality Assessment of Diagnostic Accuracy Studies tool (2) that was revealed in Tab. 1.

Second, in the statistical analysis section of this article, Zhao et al. (1) stated the weighted mean difference (WMD), standard mean difference (SMD), and relative risk (RR) were the effect sizes. Whereas, in this meta-analysis, the effect sizes actually were sensitivity and specificity showed in Fig. 4 and the WMD, SMD, and RR were not reported in the results. Therefore, we believe the irrelevant effect sizes depicted would lead to misunderstanding.

Finally, in the methods section of the abstract, randomized controlled trials (RCTs) regarding adopting color Doppler ultrasound were screened, whereas, the study was a meta-analysis of diagnostic study; then, diagnostic studies analyzing the diagnostic value of color Doppler ultrasound for thyroid nodules should be included not RCTs.

Acknowledgments

Funding: None.

Footnote

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Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-22-89/coif). The authors have no conflicts of interest to declare.

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References

1. Zhao D, Jing Y, Lin X, et al. The value of color Doppler ultrasound in the diagnosis of thyroid nodules: a systematic review and meta-analysis. Gland Surg 2021;10:3369-77. [Crossref] [PubMed]
2. Whiting PF, Weswood ME, Rutjes AW, et al. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies. BMC Med Res Methodol 2006;6:9. [Crossref] [PubMed]