Patient feedback receiving care using a shared decision making tool for thyroid nodule evaluation—an observational study

• Published in: Endocrine Vol. 80; no. 1; pp. 124 - 133
• Main Authors: Patel Chavez, Chandani Patel, Godinez Leiva, Eddison, Bagautdinova, Diliara, Hidalgo, Jessica, Hartasanchez, Sandra, Barb, Diana, Danan, Deepa, Dziegielewski, Peter, Edwards, Catherine, Hughley, Brian, Srihari, Ashok, Subbarayan, Sreevidya, Castro, M. Regina, Dean, Diana, Morris, John, Ryder, Mabel, Stan, Marius N., Hargraves, Ian, Shepel, Kathryn, Brito, Juan P., Bylund, Carma L., Treise, Debbie, Montori, Victor, Singh Ospina, Naykky
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-04-2023; Springer Nature B.V
• Subjects: Adult; Biopsy; Decision making; Decision Making, Shared; Diabetes; Endocrinology; Feedback; Female; Humanities and Social Sciences; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; multidisciplinary; Nodules; Observational studies; Original Article; Patient Participation; Patients; Referral and Consultation; Science; Thyroid; Thyroid gland; Thyroid Nodule - diagnosis; Thyroid Nodule - therapy; Shared decision making; Thyroid nodules; Thyroid cancer
• ISSN: 1559-0100; 1355-008X; 1559-0100
• DOI: 10.1007/s12020-022-03277-4

Purpose
To characterize the feedback of patients with thyroid nodules receiving care using a shared decision making (SDM) tool designed to improve conversations with their clinicians related to diagnostic options (e.g. thyroid biopsy, ultrasound surveillance).
Methods
Investigators qualitatively analyzed post-encounter interviews with patients to characterize their feedback of a SDM tool used during their clinical visits. Additionally, investigators counted instances of diagnostic choice awareness and of patients’ expression of a diagnostic management preference in recordings of clinical encounters of adult patients presenting for evaluation of thyroid nodules in which the SDM tool was used.
Results
In total, 53 patients (42 (79%) women); median age 62 years were enrolled and had consultations supported by the SDM tool. Patients were favorable about the design of the SDM tool and its ability to convey information about options and support patient-clinician interactions. Patients identified opportunities to improve the tool through adding more content and improve its use in practice through training of clinicians in its use. There was evidence of diagnostic choice awareness in 52 (98%) of these visits and patients expressed a diagnostic management preference in 40 (76%).
Conclusion
User centered design including feedback from patients and real life observation supports the use of the SDM tool to facilitate collaboration between patients and clinicians.