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Background
With the release of the 2015 American Thyroid Association (ATA) Management Guidelines for Adults with Differentiated Thyroid Cancer, treatment decisions for low-risk thyroid cancer became more complicated. Although the guidelines were meant to supplement shared patient-healthcare provider decision-making, the patient-provider deliberation often fails to meet the informational standards for patients and can often exclude available treatments. Low-risk thyroid cancer patients often don’t know what questions to ask, while the physicians report not knowing how to obtain patients’ preferences and include them into treatment decisions.
The Thyroid Cancer Treatment Choice Toolkit offers materials comparing treatment options for patients with low-risk thyroid cancer and a prompt list to help patients talk to their physicians about their cancer.
Who should use this toolkit?
This toolkit is intended for surgeons, endocrinologists, and patients with low-risk thyroid cancer and their families.
What does the toolkit contain?
The toolkit contains a PDF Treatment Comparison Chart describing the three main treatment options for patients with low-risk thyroid cancer. The toolkit also has a PDF Question Prompt List with questions patients should ask or may not know how to ask their physician.
How should these tools be used?
The materials in this toolkit can be used to:
- Treatment Comparison Chart: this tool should be used to review different treatment options for patients with localized, low-risk thyroid cancer. Patients and their families can use this tool alone prior to seeing their physician or together with their physician to compare different treatment options. Physicians can introduce this tool to patients before or during their consultation. Note that not all options are appropriate for all patients. To print the PDF, use double-sided printing.
- Question Prompt List: this tool should be used to help patients and their families think about what questions to ask their physicians about treatment for localized, low-risk thyroid cancer. The tool is intended to be used as a tri-fold brochure. To print the PDF, use double-sided printing and “flip on short edge” settings. Fold the paper in thirds so the picture is on the front flap and the questions are inside. There is room for taking notes during the visit or adding your own questions.
A copy of each instrument is available as a PDF file. The two tools can be used together or separately to support patients, their families, and physicians during the treatment decision-making process. To allow you to incorporate the instruments for your own use, they are provided as separate file in Adobe PDF that you can download on the HIPxChange site.
Development of this toolkit
The Thyroid Cancer Treatment Choice Toolkit was developed by researchers and clinicians (Principal Investigator: Susan Pitt) at the University of Wisconsin – Madison School of Medicine and Public Health – Department of Surgery, with input from a Patient and Family Advisory Board, Clinician Advisory Board, and Community Advisors on Research Design (CARDS)® group from the Wisconsin Network for Research Support.
This project was supported by the University of Wisconsin Institute for Clinical and Translational Research Patient Centered Outcomes Research Award. Additional support was provided by the University of Wisconsin School of Medicine and Public Health’s Health Innovation Program (HIP), the Wisconsin Partnership Program, and the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), grant 9 U54 TR000021 from the National Center for Advancing Translational Sciences (previously grant 1 UL1 RR025011 from the National Center for Research Resources). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funders.
Please send questions, comments and suggestions to HIPxChange@hip.wisc.edu.
References
- Pitt SC, Saucke MC. Novel Decision Support Interventions for Low-risk Thyroid Cancer. JAMA Otolaryngol Head Neck Surg. 2020 Nov 1;146(11):1079-1081
- Doubleday AR, Novin S, Long KL, Schneider DF, Sippel RS, Pitt SC. Online Information for Treatment for Low-Risk Thyroid Cancer: Assessment of Timeliness, Content, Quality, and Readability. J Cancer Educ. 2021 Aug;36(4):850-857.
- Jensen CB, Saucke MC, Francis DO, Voils CI, Pitt SC. From Overdiagnosis to Overtreatment of Low-Risk Thyroid Cancer: A Thematic Analysis of Attitudes and Beliefs of Endocrinologists, Surgeons, and Patients. Thyroid. 2020 May;30(5):696-703.
- Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016 Jan;26(1):1-133.
Toolkit Citation
Pitt S, Saucke M. Thyroid Cancer Treatment Choice Toolkit. University of Wisconsin – Madison School of Medicine and Public Health – Department of Surgery. Madison, WI; 2020. Available at http://www.hipxchange.org/ThyroidCancerTreatmentChoice.
About the Authors
Dr. Susan Pitt, MD, MPHS is an Associate Professor of Surgery and Director of Endocrine Surgery Health Services Research at the University of Michigan. Dr. Pitt also serves as the Director of Engagement at the Center for Healthcare Outcomes and Policy. In this role, she leads didactic research and career development related educations programming the Center.
Megan Saucke, MA is an Qualitative Health Services Researcher in the Wisconsin Surgical Outcomes Research Program. She holds a BA from Syracuse University and an MA in Sociology from the University of California, Davis. Megan primarily works with surgeons who are interested in using qualitative research to understand patient experiences and improve patient care. She has helped design and run multiple studies including patient and provider interviews, provider-patient consultations, focus groups, and surveys.