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Clinician feedback using a shared decision-making tool for the evaluation of patients with thyroid nodules—an observational study

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Abstract

Background

We pilot-tested an encounter conversation aid to support shared decision making (SDM) between patients with thyroid nodules and their clinicians.

Objective

Characterize the clinician feedback after providing care to patients with thyroid nodules using a tool to promote SDM conversations during the clinical encounter, and evaluate how clinicians used the tool during the visit.

Methods

Mixed method study in two academic centers in the U.S., including adult patients presenting for evaluation of thyroid nodules and their clinicians. We thematically analyzed interviews with clinicians after they used the SDM tool in at least three visits to characterize their feedback. Additionally, investigators evaluated visits recordings to determine the extent to which clinicians engaged patients in the decision-making process (OPTION score, scale 0 to 100, higher levels indicating higher involvement), the tool’s components used (fidelity), and encounter duration. Using a post-visit survey, we evaluated the extent to which clinicians felt the tool was easy to use, helpful, and supportive of the patient-clinician collaboration.

Results

Thirteen clinicians participated in the study and used the SDM tool in the care of 53 patients. Clinicians thought the tool was well-organized and beneficial to patients and clinicians. Clinicians noticed a change in their routine with the use of the conversation aid and suggested it needed to be more flexible to better support varying conversations. The median OPTION score was 34, the fidelity of use 75%, and the median visit duration 17 min. In most encounters, clinicians agreed or strongly agreed the tool was easy to use (86%), helpful (65%), and supported collaboration (62%).

Conclusion

Clinicians were able to use a SDM tool in the care of patients with thyroid nodules. Although they wished it were more flexible, they found on the whole that its use in the clinical encounter was beneficial to patients and clinicians.

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Funding

This work was supported by the Clinical and Translational Science Institute (CTSI) grant support (NIH National Center for Advancing Translational Sciences (NCATS) grant UL1 TR000064). N.S.O. was supported by the National Cancer Institute of the National Institutes of Health under Award Number K08CA248972. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA

    Naykky Singh Ospina, Chandani Patel Chavez, Eddison Godinez Leiva, Diana Barb, Ashok Srihari & Sreevidya Subbarayan

  2. College of Journalism and Communications, University of Florida, Gainesville, FL, USA

    Diliara Bagautdinova & Debbie Treise

  3. Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA

    Jessica Hidalgo, Sandra Hartasanchez, Sandra Algarin Perneth, Ian Hargraves, Victor M. Montori & Juan P. Brito

  4. Department of Otolaryngology, University of Florida, Gainesville, FL, USA

    Deepa Danan, Peter Dziegielewski & Brian Hughley

  5. Division of Endocrinology, Mayo Clinic, Rochester, MN, USA

    M. Regina Castro, Diana Dean, John Morris, Mabel Ryder, Marius N. Stan, Victor M. Montori & Juan P. Brito

  6. Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA

    Carma L. Bylund

Authors
  1. Naykky Singh Ospina
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  2. Chandani Patel Chavez
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  4. Diliara Bagautdinova
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  8. Diana Barb
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  11. Brian Hughley
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  13. Sreevidya Subbarayan
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  14. M. Regina Castro
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  15. Diana Dean
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  16. John Morris
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  17. Mabel Ryder
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  18. Marius N. Stan
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  21. Debbie Treise
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  22. Victor M. Montori
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  23. Juan P. Brito
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Contributions

N.S.O., C.L.B. and J.P.B. conceptualized and designed the study. N.S.O., C.P.C. and C.L.B. conducted the qualitative analysis. N.S.O. wrote the first draft of the manuscript. All authors assisted in the interpretation of the clinical findings, provided critical feedback on the manuscript, and approved the revised version.

Corresponding author

Correspondence to Naykky Singh Ospina.

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Singh Ospina, N., Patel Chavez, C., Godinez Leiva, E. et al. Clinician feedback using a shared decision-making tool for the evaluation of patients with thyroid nodules—an observational study. Endocrine 83, 449–458 (2024). https://doi.org/10.1007/s12020-023-03519-z

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  • DOI: https://doi.org/10.1007/s12020-023-03519-z

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