NATIONAL SURVEY OF ENDOCRINOLOGISTS AND SURGEONS REGARDING ACTIVE SURVEILLANCE FOR LOW-RISK PAPILLARY THYROID CANCER.
NATIONAL SURVEY OF ENDOCRINOLOGISTS AND SURGEONS REGARDING ACTIVE SURVEILLANCE FOR LOW-RISK PAPILLARY THYROID CANCER.
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DOI：
10.1016/j.eprac.2020.11.003
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Pitt SC
中科院分区：
文献类型：
--
作者：
Roman BR;Brito JP;Saucke MC;Lohia S;Jensen CB;Zaborek N;Jennings JL;Tuttle RM;Davies L;Pitt SC
低风险乳头状甲状腺癌（PTC）的积极监测在2015年得到了美国甲状腺协会指南的认可。治疗甲状腺癌的医生对积极监测方法的态度和信念尚不清楚。2017年8月至9月，通过专业协会电子邮件对治疗甲状腺癌的内分泌学家和外科医生进行了一项全国性调查。该混合方法分析报告了对影响主动监测决策的潜在因素的态度，对其使用的障碍和促进因素的信念，以及医生在被诊断为低风险PTC时为自己选择特定管理策略的原因。调查项目的态度和信念来自卡巴纳模型的障碍，以指导方针的遵守和理论领域框架的行为改变。在345名受访者中，324名（94%）同意至少对某些患者进行主动监测，81%的受访者同意主动监测至少在某种程度上未得到充分利用，76%的受访者表示，如果诊断出PTC ≤1 cm，他们会选择手术。大部分受访者认为，支持积极监察的指引过于含糊，而现时的支持证据亦过于薄弱。渎职和财务问题被认为是提供积极监督的额外障碍。答复者赞同改进信息资源和证据，认为这可能有助于提供积极的监测。尽管治疗低风险PTC的医生普遍支持主动监测方法，但由于缺乏强有力的证据、指南和方案，他们不愿意提供这种方法。
Active surveillance for low-risk papillary thyroid cancer (PTC) was endorsed by the American Thyroid Association guidelines in 2015. The attitudes and beliefs of physicians treating thyroid cancer regarding the active surveillance approach are not known. A national survey of endocrinologists and surgeons treating thyroid cancer was conducted from August to September 2017 via professional society emails. This mixed-methods analysis reported attitudes toward potential factors impacting decision-making regarding active surveillance, beliefs about barriers and facilitators of its use, and reasons why physicians would pick a given management strategy for themselves if they were diagnosed with a low-risk PTC. Survey items about attitudes and beliefs were derived from the Cabana model of barriers to guideline adherence and theoretical domains framework of behavior change. Among 345 respondents, 324 (94%) agreed that active surveillance was appropriate for at least some patients, 81% agreed that active surveillance was at least somewhat underused, and 76% said that they would choose surgery for themselves if diagnosed with a PTC of ≤1 cm. Majority of the respondents believed that the guidelines supporting active surveillance were too vague and that the current supporting evidence was too weak. Malpractice and financial concerns were identified as additional barriers to offering active surveillance. The respondents endorsed improved information resources and evidence as possible facilitators to offering active surveillance. Although there is general support among physicians who treat low-risk PTC for the active surveillance approach, there is reluctance to offer it because of the lack of robust evidence, guidelines, and protocols.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
DOI：
10.1089/thy.2017.0227
发表时间：
2018-01
期刊：
Thyroid : official journal of the American Thyroid Association
影响因子：
--
作者：
Miyauchi A;Ito Y;Oda H
通讯作者：
Oda H
影响因子：
6.6
作者：
Ito, Yasuhiro;Miyauchi, Akira;Miya, Akihiro
通讯作者：
Miya, Akihiro
影响因子：
7.8
作者：
Davies, Louise;Roman, Benjamin R.;Miyauchi, Akira
通讯作者：
Miyauchi, Akira
影响因子：
5.8
作者：
Molinaro, Eleonora;Campopiano, Maria Cristina;Elisei, Rossella
通讯作者：
Elisei, Rossella