Shared Decision-Making Principles in the Nonsurgical Management of Thyroid Nodules

PROGRAM DESCRIPTION: Ultrasound guided non-surgical management options for nodules and other thyroid pathology are becoming widely available. Radiofrequency ablation (RFA) and ethanol ablation (EA) are now utilized to reduce the size of symptomatic benign thyroid lesions, ablate indeterminate and malignant nodules, and treat recurrent disease. Variably performed by otolaryngologists and interventional radiologists, knowledge of which patients may benefit from this minimally invasive treatment is key.

Decision-making surrounding the use of RFA and EA can be complex and often involves multi-disciplinary teams. Shared decision-making, which integrates the patient’s values and preferences with the medical expertise of the treating team, can be utilized to determine optimal, patient-centered treatment choices, reduce decisional conflict, and improve cognitive-affective outcomes.

This panel intends to describe the role of non-surgical treatments for the management of benign thyroid nodules, including indications, expected outcomes, and how the procedure may be performed. Further, this panel will describe the requisite decision-making required before pursuing these treatments for patients, and how the principles of shared decision-making may be employed in this pathway.

OUTCOME OBJECTIVE 1: Recognize the role and indications of RFA and EA in the management of thyroid nodules

OUTCOME OBJECTIVE 2: Highlight the symptom and quality of life related outcomes of RFA and EA for benign thyroid nodules

OUTCOME OBJECTIVE 3: Describe the process of shared decision-making and its relevance to decision making in the non-surgical management of thyroid nodules

BACKGROUND STATEMENT: Radiofrequency ablation and ethanol ablation for thyroid nodules are becoming more common and there is an increasing need to recognize in which clinical scenarios they may be utilized.