Impact of Emotions on Treatment Decisions About Low-Risk Thyroid Cancer

情绪对低风险甲状腺癌治疗决策的影响

• 批准号: 10790089
• 负责人: Susan C Pitt
• 金额: $ 14.24万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-11 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10790089
• 关键词: Address; Affect; Age; Anxiety; Attention; Behavior; Behavior Therapy; Benign; COVID-19; Cognition; Cognitive; Communication; Decision Making; Deglutition; Diagnosis; Disease; Education; Educational Intervention; Effectiveness of Interventions; Emotional; Emotions; Exercise; Experimental Psychology; Fatigue; Feeling; Foundations; Fright; Funding; Goals; Harm Reduction; Health; Health Services; Incidence; International; Intervention; K-Series Research Career Programs; Knowledge; Longevity; Malignant Neoplasms; Malignant neoplasm of thyroid; Measurement; Mentors; Methodology; Mind; Modeling; Morbidity - disease rate; Muscle Cramp; Operative Surgical Procedures; Outcome; Patient Preferences; Patients; Pharmaceutical Preparations; Postoperative Period; Prognosis; Psychology; Public Health; Qualitative Research; Quality of life; Randomized; Reflex action; Research; Research Personnel; Risk; Role; Science; Scientist; Societies; Surgeon; Testing; Tetany; Thyroid Gland; Thyroid Nodule; Thyroidectomy; Time; Training; Treatment outcome; Treatment-Related Cancer; United States; Vocal Cord Paralysis; Woman; Work; analog; anxiety reduction; behavior test; behavioral economics; cancer diagnosis; cancer risk; cancer therapy; care costs; career; clinically significant; comparative; cost; design; disorder risk; effective intervention; effectiveness testing; experience; experimental study; improved; innovation; insight; mortality; multidisciplinary; overtreatment; peace; preference; psychologic; risk perception; simulation; skills; social; theories; treatment effect; tumor

PROJECT SUMMARY This K08 Career Development Award will address important gaps in the training of the applicant while simultaneously generating new knowledge about the role of emotions in cancer-related treatment decisions, a priority of the NCI. The incidence of thyroid cancer has increased at a rate faster than any other cancer, largely due to increased diagnosis of small, low-risk cancers  2 cm with a 10-year mortality close to zero. Overtreatment with total thyroidectomy occurs in the vast majority of these patients, resulting in significant harms, excess morbidity, and costs to both patients and society without a clear benefit. Currently, a lack of understanding about why patients prefer this extensive treatment limits our ability to reduce overtreatment of low-risk disease. The proposed research seeks to address this gap by investigating the impact of emotions on treatment decisions about small, low-risk thyroid cancer. The coordinated research and training proposal aims to: 1) characterize the emotional and cognitive communication between patients and surgeons during treatment decision making; 2) determine the relative value of treatment outcomes to patients undergoing total thyroidectomy at the time of the decision compared to one year postoperatively; and 3) test the extent to which increased emotionally supportive communication by surgeons is associated with decreased patient preference for total thyroidectomy. The central hypothesis is that is that emotions, such as fear and anxiety, influence patient-surgeon decision making about treatment for small, low-risk thyroid cancer leading to decisions that over treat. Completion of these aims will facilitate mentored-training in decision science that is vital to Dr. Pitt’s career goals. The proposed training will fill key educational and experiential gaps in the psychology of decision making and behavioral economics, which will be accompanied by methodologic training in qualitative research, preference measurement, choice experimentation, and factorial design. The applicant will draw upon the strengths of a diverse group of nationally and internationally recognized mentors with multidisciplinary expertise in experimental psychology, surgical decision-making, behavioral economics, and thyroid cancer treatment. This mentored training will support the applicant in becoming a successful surgeon-scientist with unique research skills. The results of the proposed research will provide new understanding about the specific role of emotions and emotionally supportive communication in treatment decisions in a low-risk cancer. At the end of the proposed training period, Dr. Pitt will have the results and experience necessary to obtain R01 funding to adapt and test behavioral and educational interventions that incorporate emotional support, thus reducing the harms and costs of overtreatment.

项目概要 K08 职业发展奖将弥补申请人培训中的重要差距，同时 同时产生关于情绪在癌症相关治疗决策中的作用的新知识， NCI 的优先级。甲状腺癌的发病率增长速度比任何其他癌症都要快，在很大程度上 由于小于 2 厘米的小型低风险癌症的诊断增加，10 年死亡率接近于零。 绝大多数患者都接受了甲状腺全切除术的过度治疗，导致显着的 对患者和社会造成伤害、过高的发病率和成本，却没有明显的好处。目前，缺乏 了解为什么患者喜欢这种广泛的治疗限制了我们减少过度治疗的能力 低风险疾病。拟议的研究旨在通过调查情绪对人的影响来解决这一差距 关于小型、低风险甲状腺癌的治疗决策。协调研究和培训提案的目的 1）描述患者和外科医生之间的情感和认知沟通 治疗决策； 2) 确定治疗结果对接受总治疗的患者的相对价值 做出决定时的甲状腺切除术与术后一年的比较； 3）测试其程度 外科医生增加情感支持性沟通与患者偏好降低相关 用于甲状腺全切除术。中心假设是恐惧和焦虑等情绪会影响 患者与外科医生关于治疗小型低风险甲状腺癌的决策导致以下决策： 过度治疗。完成这些目标将促进决策科学方面的指导培训，这对皮特博士的研究至关重要 职业目标。拟议的培训将填补决策心理学方面的关键教育和经验空白 制造和行为经济学，其中将伴随定性研究的方法培训， 偏好测量、选择实验和因子设计。申请人将利用 国内和国际公认的多学科导师组成的多元化团队的优势 实验心理学、手术决策、行为经济学和甲状腺癌方面的专业知识 治疗。这种指导培训将支持申请人成为一名成功的外科医生科学家 独特的研究技能。拟议研究的结果将为具体问题提供新的理解 情绪和情感支持性沟通在低风险癌症治疗决策中的作用。在 在建议的培训期结束后，皮特博士将获得获得 R01 所需的结果和经验 提供资金来适应和测试包含情感支持的行为和教育干预措施，从而 减少过度治疗的危害和成本。

项目成果

NATIONAL SURVEY OF ENDOCRINOLOGISTS AND SURGEONS REGARDING ACTIVE SURVEILLANCE FOR LOW-RISK PAPILLARY THYROID CANCER.

• DOI: 10.1016/j.eprac.2020.11.003
• 发表时间: 2021-01
• 期刊: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
• 作者: Roman BR;Brito JP;Saucke MC;Lohia S;Jensen CB;Zaborek N;Jennings JL;Tuttle RM;Davies L;Pitt SC
• 通讯作者: Pitt SC

Physician Perspectives of Overdiagnosis and Overtreatment of Low-Risk Papillary Thyroid Cancer in the US.

美国医生对低风险甲状腺乳头状癌过度诊断和过度治疗的看法。

• DOI: 10.1001/jamanetworkopen.2022.8722
• 发表时间: 2022-04-01
• 期刊: JAMA NETWORK OPEN
• 影响因子: 13.8
• 作者: Dedhia, Priya H.;Saucke, Megan C.;Long, Kristin L.;Doherty, Gerard M.;Pitt, Susan C.
• 通讯作者: Pitt, Susan C.

Words Do Matter: Improving Surgical Research Through Appropriate Use of Sex, Gender, Race, and Ethnicity Terminology.

词语确实很重要：通过适当使用性、性别、种族和民族术语来改进外科研究。

• DOI: 10.1016/j.jamcollsurg.2021.05.022
• 发表时间: 2021
• 期刊: Journal of the American College of Surgeons
• 影响因子: 5.2
• 作者: Pitt,SusanC

The Role of Node Dissection for Thyroid Cancer.

• DOI: 10.1016/j.yasu.2021.05.010
• 发表时间: 2021-09
• 期刊: Advances in surgery
• 作者: Randle RW;Pitt SC
• 通讯作者: Pitt SC

Active surveillance for thyroid Cancer: a qualitative study of barriers and facilitators to implementation.

• DOI: 10.1186/s12885-021-08230-8
• 发表时间: 2021-04-28
• 期刊: BMC cancer
• 影响因子: 3.8
• 作者: Jensen CB;Saucke MC;Pitt SC
• 通讯作者: Pitt SC