Preoperative Difficulty Index for Thyroidectomy (PreoDIT™): A Novel, Reliable, Content Valid, and Valuable Tool


  • Talat Waseem
  • Zaitoon Zafar Shalamar Medical and Dental College
  • Safia Zahir Ahmed
  • M Hasham Ashraf



thyroidectomy, endocrine surgery, surgical oncology, quality improvement, PreoDIT


Background: A thyroidectomy can be a complex operation, currently there are no preoperative tools available to predict cases which may prove to be challenging procedures, or tools to grade potential thyroid procedures according to difficulty, based on a pre-operative assessment. The aim of this study is to develop such a tool; the Preoperative Difficulty Index for Thyroidectomy (PreoDIT™) and assess its reliability and validity.

Materials and methods: To define factors contributing to the complexity of a thyroidectomy, qualitative methods were used to retrieve qualitative data, in addition to an extensive literature review. A focus group was arranged in which a panel of 8 experts with extensive experience in thyroid surgery participated; and a tool, PreoDIT™, was developed. This tool was then utilized on 513 patients to test it’s reliability, validity and efficiency.

Results: PreoDIT™ scores strongly correlated with operative times, blood loss and postoperative complications; proving the reliability of this novel tool.

Conclusion: PreoDIT™ is a reliable and valid tool to measure the difficulty index of a thyroidectomy. This tool was designed to help surgeons optimize and manage their teams, operation theatre resources and resident training in a more objective way, before committing to a procedure.


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Preoperative Difficulty Index for Thyroidectomy (PreoDIT™): A Novel, Reliable, Content Valid, and Valuable Tool. (2022). Archives of Surgical Research, 2(4), 5-11.

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