Thyroid Cancer Patient Perceptions of Radioactive Iodine Treatment Choice: Follow-up from a Decision-aid Randomized Trial

Overview

Journal Cancer

Publisher Wiley

Specialty Oncology

Date 2015 Jul 22

PMID 26195199

Citations 7

Authors

Anna M Sawka

Sharon Straus

Gary Rodin

Lineke Heus

James D Brierley

Richard W Tsang

Lorne Rotstein

Shereen Ezzat

Phillip Segal

Amiram Gafni

Kevin E Thorpe

David P Goldstein

Affiliations

Soon will be listed here.

Abstract

Background: Patient decision aids (P-DAs) inform medical decision making, but longer term effects are unknown. This article describes extended follow-up from a thyroid cancer treatment P-DA trial.

Methods: In this single-center, parallel-design randomized controlled trial conducted at a Canadian tertiary/quaternary care center, early-stage thyroid cancer patients from a P-DA trial were contacted 15 to 23 months after randomization/radioactive iodine (RAI) decision making to evaluate longer term outcomes. It was previously reported that the use of the computerized P-DA in thyroid cancer patients considering postsurgical RAI treatment significantly improved medical knowledge in comparison with usual care alone. The P-DA and control groups were compared for the following outcomes: feeling informed about the RAI treatment choice, decision satisfaction, decision regret, cancer-related worry, and physician trust. In a subgroup of 20 participants, in-depth interviews were conducted for a qualitative analysis.

Results: Ninety-five percent (70 of 74) of the original population enrolled in follow-up at a mean of 17.1 months after randomization. P-DA users perceived themselves to be significantly more 1) informed about the treatment choice (P = .008), 2) aware of options (P = .009), 3) knowledgeable about treatment benefits (P = .020), and 4) knowledgeable about treatment risks/side effects (P = .001) in comparison with controls. There were no significant group differences in decision satisfaction (P = .142), decision regret (P = .199), cancer-related worry (P = .645), mood (P = .211), or physician trust (P = .764). In the qualitative analysis, the P-DA was perceived to have increased patient knowledge and confidence in decision making.

Conclusions: The P-DA improved cancer survivors' actual and long-term perceived medical knowledge with no adverse effects. More research on the long-term outcomes of P-DA use is needed.

Citing Articles

Decision aids for people facing health treatment or screening decisions.

Stacey D, Lewis K, Smith M, Carley M, Volk R, Douglas E Cochrane Database Syst Rev. 2024; 1:CD001431.

PMID: 38284415 PMC: 10823577. DOI: 10.1002/14651858.CD001431.pub6.

Current Controversies in Low-Risk Differentiated Thyroid Cancer: Reducing Overtreatment in an Era of Overdiagnosis.

Ullmann T, Papaleontiou M, Sosa J J Clin Endocrinol Metab. 2022; 108(2):271-280.

PMID: 36327392 PMC: 10091361. DOI: 10.1210/clinem/dgac646.

Multilevel Factors Associated With More Intensive Use of Radioactive Iodine for Low-Risk Thyroid Cancer.

Wallner L, Banerjee M, Reyes-Gastelum D, Hamilton A, Ward K, Lubitz C J Clin Endocrinol Metab. 2021; 106(6):e2402-e2412.

PMID: 33687063 PMC: 8118575. DOI: 10.1210/clinem/dgab139.

Thyroid cancer patients satisfaction at the management outcome: an analysis of the results of a nationwide survey in 485 subjects.

Diez J, Galofre J BMC Health Serv Res. 2021; 21(1):158.

PMID: 33602247 PMC: 7890898. DOI: 10.1186/s12913-021-06158-0.

Factors associated with physicians' recommendations for managing low-risk papillary thyroid cancer.

McDow A, Roman B, Saucke M, Jensen C, Zaborek N, Jennings J Am J Surg. 2020; 222(1):111-118.

PMID: 33248684 PMC: 8262457. DOI: 10.1016/j.amjsurg.2020.11.021.

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