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Updated: Nov 7, 2025

Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
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Exploring physicians and patients' perspectives for current interventions on thyroid nodules using a MCDA method.

Linda Karrer1, Shixuan Zhang2, Thomas Kühlein3

  • 1Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander-University of Erlangen-Nuremberg, Erlange, Bavaria, Germany.

Cost Effectiveness and Resource Allocation : C/E
|May 2, 2021
PubMed
Summary

Physicians prioritize intervention safety and effectiveness, while patients value quality of life in thyroid nodule management. Understanding these differing preferences can improve communication and decision-making for thyroid cancer interventions.

Keywords:
Adverse Cascade EffectsEVIDEMHealth Technology Assessment (HTA)MCDAMulti criteria decision AnalysisOverdiagnosisThyroid nodules

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Area of Science:

  • Endocrinology
  • Oncology
  • Health Services Research

Background:

  • Thyroid cancer detection has increased, yet mortality remains stable, suggesting potential over-diagnosis and overtreatment of thyroid nodules.
  • Routine ultrasound diagnosis of thyroid nodules may lead to prolonged follow-up or unnecessary invasive treatments.
  • Understanding patient and physician perspectives is crucial for optimizing thyroid nodule management strategies.

Purpose of the Study:

  • To explore and compare physicians' and patients' insights and preferences regarding current interventions for thyroid nodules.
  • To identify key criteria influencing decision-making in thyroid nodule management from both patient and physician viewpoints.

Main Methods:

  • An online survey utilizing the Evidence-based Decision-Making (EVIDEM) multi-criteria decision analysis (MCDA) framework was employed.
  • Participants (48 patients, 31 physicians) assigned weights to 13 quantitative and 4 qualitative criteria and scored intervention performance.
  • Value contributions were calculated, and differences between physician and patient groups were analyzed.

Main Results:

  • Overall value estimates for interventions were 0.549 for patients and 0.5 for physicians.
  • 'Comparative effectiveness' was the highest value contributor overall.
  • Physicians prioritized 'Comparative safety,' while patients emphasized 'Type of preventive benefits.'
  • A significant percentage of participants noted negative impacts from 'Population priorities and access' and 'system capacity.'

Conclusions:

  • Physicians prioritize intervention safety and effectiveness, whereas patients place greater importance on post-intervention quality of life.
  • Highlighting these differing preferences can enhance physician-patient communication regarding thyroid nodule interventions.
  • The findings support shared decision-making processes for healthcare providers managing thyroid nodules.