Patient Preferences Around Extent of Surgery in Low-Risk Thyroid Cancer: A Discrete Choice Experiment
| العنوان: | Patient Preferences Around Extent of Surgery in Low-Risk Thyroid Cancer: A Discrete Choice Experiment |
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| المؤلفون: | Maya Talbott, Randall P. Scheri, Sara Ahmadi, Shelby D. Reed, Jui-Chen Yang, Julie Ann Sosa, Juan Marcos Gonzalez, Sanziana A. Roman, Michael T. Stang |
| المصدر: | Thyroid. 30:1044-1052 |
| بيانات النشر: | Mary Ann Liebert Inc, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Thyroid Gland, 030209 endocrinology & metabolism, Discrete choice experiment, Logistic regression, Cancer recurrence, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Risk Factors, Preoperative Care, medicine, Humans, Postoperative Period, Thyroid Neoplasms, Thyroid Nodule, Thyroid cancer, Total thyroidectomy, business.industry, Thyroid, Patient Preference, Middle Aged, medicine.disease, Health Surveys, Patient preference, Surgery, medicine.anatomical_structure, Thyroid Cancer, Papillary, 030220 oncology & carcinogenesis, Thyroidectomy, Female, Neoplasm Recurrence, Local, business, Hormone |
| الوصف: | Background: Patient preferences pertaining to surgical options for thyroid cancer management are not well studied. Our aim was to conduct a discrete choice experiment (DCE) to characterize participants' views on the relative importance of various risks and benefits associated with lobectomy versus total thyroidectomy for low-risk thyroid cancer. Methods: Adult participants with low-risk thyroid cancer or a thyroid nodule requiring surgery were asked to choose between experimentally designed surgical options with varying levels of risk of nerve damage (1%, 9%, 14%), hypocalcemia (0%, 3%, 8%), risk of needing a second surgery (0%, 40%), cancer recurrence (1%, 3%, 5%), and need for daily thyroid hormone supplementation (yes, no). Their choices were analyzed using random-parameters logit regression. Results: One hundred fifty participants completed an online DCE survey. Median age was 58 years; 82% were female. Twenty-four participants (16%) had a diagnosis of thyroid cancer at the time of completing the survey, and 126 (84%) had a thyroid nodule necessitating surgery. On average, 35% of participants' choices were explained by differences in the risk of cancer recurrence; 28% by the chance of needing a second surgery; 19% by the risk of nerve damage; and 9% by differences in risks of hypocalcemia and the need for thyroid hormone supplementation. When accounting for differences in postoperative risks, the average patient favored lobectomy over total thyroidectomy as long as the chance of needing a second (i.e., completion) surgery after initial lobectomy remained below 30%. Participants would accept a 4.1% risk of cancer recurrence if the risk of a second surgery could be reduced from 40% to 10%. Conclusions: While patients with thyroid cancer may have clear preferences for extent of surgery, common themes moderating preferences for surgical interventions were identified in the DCE. Adequate preoperative evaluation to decrease the chance of a second surgery and providing patients with a good understanding of risks and benefits associated with extent of surgery can lead to better treatment decision-making. |
| تدمد: | 1557-9077 1050-7256 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dab32d74de51df5238530bae871ab14eTest https://doi.org/10.1089/thy.2019.0590Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....dab32d74de51df5238530bae871ab14e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15579077 10507256 |
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