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Patients’ knowledge about the outcomes of thyroid biopsy: a patient survey

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Abstract

Purpose

Fine-needle aspiration biopsy of the thyroid is an increasingly common outpatient procedure. Patients are counseled about the indications and risks of this procedure and informed consent is obtained. We aimed to assess the extent to which patients acquired necessary knowledge during this process.

Methods

Survey study conducted in a thyroid nodule clinic at a referral center. Adult patients who had just undergone a thyroid biopsy were asked to complete a survey, including eight questions regarding the indications and potential outcomes of thyroid biopsy. The main outcome of the study was to assess the patients’ knowledge based on the response to each individual survey question.

Results

Two-hundred and ninety-seven patients were eligible, of which 196 (66%) completed the survey: most were women (76%), had adequate reading health literacy (95%) and a mean age of 58 years. Although 86% of patients correctly identified evaluation for thyroid cancer as the main indication for their biopsy, 56% were not aware of the likelihood of this diagnosis. Almost all (>90%) of respondents knew that results could be benign or malignant; fewer were aware of non-diagnostic (71%) or indeterminate (68%) outcomes, or of the need for additional diagnostic testing after the biopsy (33%).

Conclusions

After undergoing thyroid biopsy, a high proportion of well-educated patients remained unaware of their risk for thyroid cancer, potential outcomes, and downstream consequences of their biopsy. This quality gap raises the possibility that informed consent procedures that meet legal standards may leave patients undergoing thyroid biopsy paradoxically uninformed.

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Funding

This publication was made possible by CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Juan P. Brito is supported by the Karl-Erivan Haub Family Career Development Award in Cancer Research at Mayo Clinic in Rochester, honoring Richard F. Emslander, M.D. Spyridoula Maraka is supported by the Arkansas Biosciences Institute, the major research component of the Arkansas Tobacco Settlement Proceeds Act of 2000.

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Authors and Affiliations

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

    Naykky Singh Ospina

  2. Knowledge and Evaluation Research Unit in Endocrinology (KER-Endo), Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Naykky Singh Ospina, Juan P. Brito, Spyridoula Maraka, Claudia Zeballos Palacios & Victor M. Montori

  3. Department of Emergency Medicine, Aventura Hospital and Medical Center, Miami, FL, USA

    Ana Castaneda-Guarderas

  4. Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Russell Ward, Juan P. Brito, Diana S. Dean & Victor M. Montori

  5. Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock, AR, USA

    Spyridoula Maraka

  6. Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

    Kathleen J. Yost

Authors
  1. Naykky Singh Ospina
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  2. Ana Castaneda-Guarderas
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  3. Russell Ward
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  9. Victor M. Montori
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Corresponding author

Correspondence to Victor M. Montori.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was conducted in accordance with ethical standards and with approval of the institutional research board.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Singh Ospina, N., Castaneda-Guarderas, A., Ward, R. et al. Patients’ knowledge about the outcomes of thyroid biopsy: a patient survey. Endocrine 61, 482–488 (2018). https://doi.org/10.1007/s12020-018-1639-8

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  • DOI: https://doi.org/10.1007/s12020-018-1639-8

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