The Effect of a Surgeon Communication Strategy on Treatment Preference for Thyroid Cancer: A Randomized Trial

Area of Science:

• Oncology
• Surgical Communication
• Patient-Centered Care

Background:

• Emotional distress from cancer diagnosis impacts patient treatment decisions.
• Virtual settings are increasingly used for patient consultations.
• The role of empathetic communication in surgical decision-making for thyroid cancer requires investigation.

Purpose of the Study:

• To assess the impact of enhanced emotionally supportive surgeon communication in a virtual setting on treatment preference for low-risk thyroid cancer.
• To evaluate the effect of communication style on perceived physician empathy, trust, decisional confidence, and knowledge.

Main Methods:

• A randomized controlled trial (NCT05132478) involving adults with low-risk thyroid nodules.
• Participants viewed virtual clinic visits with either standard or enhanced emotionally supportive surgeon communication.
• Treatment preference (thyroidectomy vs. lobectomy) and secondary outcomes were assessed using regression analysis and qualitative content analysis.

Main Results:

• Enhanced communication did not significantly alter treatment preference, with most participants favoring lobectomy.
• Participants exposed to enhanced communication reported significantly higher perceived physician empathy (P < 0.001) and physician trust (P < 0.001).
• Decisional confidence and disease-specific knowledge remained similar between groups.

Conclusions:

• While enhanced emotionally supportive communication did not change treatment choices for low-risk thyroid cancer, it significantly improved patient-reported empathy and trust.
• Empathetic communication, even in virtual settings, is crucial for fostering positive patient-physician relationships.
• Patient preferences for lobectomy were primarily driven by a desire to avoid daily thyroid hormone replacement and concerns about surgical complications.