Evidence map›Paper›PMID 28175931›Full record

ArticleWorld journal of surgery2017

Determining Patient Preferences for Indeterminate Thyroid Nodules: Observation, Surgery or Molecular Tests.

Daniel Joonil Lee, Jason J Xu, Dale H Brown, Ralph W Gilbert, Patrick J Gullane, Jonathan C Irish, Lorne E Rotstein, David P Goldstein, John R de Almeida

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Article in World journal of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Daniel Joonil LeeFaculty of Medicine, University of Toronto, Toronto, ON, Canada.
Jason J XuDepartment of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Dale H BrownDepartment of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Ralph W GilbertDepartment of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Patrick J GullaneDepartment of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Jonathan C IrishDepartment of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Lorne E RotsteinDepartment of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
David P GoldsteinDepartment of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
John R de AlmeidaDepartment of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada. john.dealmeida@uhn.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGene-expression classifiers (GEC) and genetic mutation panels (GMP) have been shown to improve preoperative diagnostic evaluations of indeterminate thyroid nodules. Despite the improvement, uncertainty regarding the proper management exists. Patient preferences may better inform the management of these indeterminate thyroid nodules.

methodsHypothetical scenarios were administered to two groups of patients: those with previous FNA-confirmed indeterminate thyroid nodules (Group A, n = 50) and those presenting to a general otolaryngology clinic for other reasons (Group B, n = 50). We evaluated patient preferences for surgery, observation and the use of molecular tests while varying the risk of malignancy, cost and diagnostic properties of the tests.

resultsThe mean threshold for choosing surgery over observation was a 38.6% risk of malignancy on FNA. When offered either GEC, GMP or both (with their inherent imperfect diagnostic properties) in addition to the indeterminate FNA, 85.0% of respondents picked at least one of the molecular tests over either observation or surgery if the test(s) were free of charge. However, only 51.7% of respondents chose at least one of the tests when asked to pay the current cost of the test(s) (p < 0.001). On multivariable analysis, sex, the presence of an indeterminate FNA diagnosis and income level significantly predicted the desire to proceed with a molecular test above standard management.

conclusionPatient preferences for thyroid nodule management are dependent on the risk of malignancy, prognosis of cancer and costs. Patients prefer molecular tests over standard management with indeterminate thyroid nodules, but the costs of the test(s) reduce the desire.

Indexed as

Patient PreferenceAdultAgedAged, 80 and overBiopsy, Fine-NeedleFemaleHumansMaleMiddle AgedMutationThyroid Nodule

Identifiers

PMID28175931

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.