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A Survey of American Thyroid Association Members Regarding the 2015 Adult Thyroid Nodule and Differentiated Thyroid
Anna M Sawka1, Anna R Gagliardi2, Megan R Haymart3
1Division of Endocrinology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Abstract:
The 2015 American Thyroid Association (ATA) clinical practice guidelines (CPGs) on management of thyroid nodules (TNs) and differentiated thyroid cancer (DTC) in adults were developed to inform clinicians, patients, researchers, and health policy makers about the best available evidence, and its limitations, relating to management of these conditions. We conducted a cross-sectional electronic survey of ATA members' perspectives of these CPGs, using a standardized survey (Clinician Guidelines Determinant Questionnaire) developed by the Guidelines International Network. A survey link was electronically mailed to members in February of 2019, with reminders sent to nonrespondents 2 and 5 weeks later. Data were descriptively summarized, after excluding missing responses. The overall response rate was 19.8% (348/1761). The effective response rate was 20.2% (348/1720), after excluding a recently deceased member and individuals who had either invalid e-mail addresses or whose e-mails were returned. Of the respondents, 37.9% (132/348) were female, 60.4% (209/346) were endocrinologists, 27.5% (95/346) were surgeons, and 3.5% (12/346) were nuclear medicine specialists. The majority of respondents (71.9%; 250/348) were at a mid- or advanced-career level, and more than half were in academia (57.5%; 195/339). The majority (69.8%; 243/348) practiced in North America. The vast majority of respondents indicated that the CPGs explained the underlying evidence (92.3%; 298/323) and 92.9% (300/323) agreed or strongly agreed with the content. Most respondents stated that they regularly used the CPGs in their practice (83.0%; 268/323). Most respondents (83.0%; 268/323) also agreed or strongly agreed that the recommendations were easy to incorporate in their practice. The most popular CPG format was an electronic desktop file (78.8%; 252/320). Shorter more frequent CPGs were favored by 55.0% (176/320) of respondents, and longer traditional CPGs were favored by 39.7% (127/320). The clinical content and evidence explanations in the adult TN and DTC CPGs are widely accepted and applied among ATA survey respondents. Future ATA CPG updates need to be optimized to best meet users' preferences regarding format, frequency, and length.
Insights
The 2015 American Thyroid Association (ATA) clinical practice guidelines (CPGs) for thyroid nodules and differentiated thyroid cancer are widely accepted by clinicians. Future guideline updates should consider user preferences for format, frequency, and length.
Area of Science:
- Endocrinology
- Oncology
- Clinical Practice Guidelines
Background:
- The 2015 American Thyroid Association (ATA) clinical practice guidelines (CPGs) provide evidence-based recommendations for managing thyroid nodules (TNs) and differentiated thyroid cancer (DTC) in adults.
- These guidelines aim to inform clinicians, patients, researchers, and policymakers on the best available evidence and its limitations.
Purpose of the Study:
- To assess the perspectives of ATA members on the 2015 ATA CPGs for TN and DTC management.
- To understand clinician acceptance, application, and preferences for future guideline development.
Main Methods:
- A cross-sectional electronic survey using the Clinician Guidelines Determinant Questionnaire was distributed to ATA members.
- Data were collected and descriptively summarized, with a response rate of 19.8%.
Main Results:
- The majority of respondents (92.3%) found that the CPGs explained the underlying evidence well.
- Most respondents (92.9%) agreed with the CPG content and (83.0%) regularly used them in practice.
- Electronic desktop files were the preferred format (78.8%), with a preference for shorter, more frequent guidelines (55.0%).
Conclusions:
- The clinical content and evidence explanations of the adult TN and DTC CPGs are well-received and utilized by ATA members.
- Future ATA CPG updates should prioritize user preferences regarding format, frequency, and length for optimal implementation.
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