Difficult decisions in endocrine surgery : an evidence-based approach

Description

Acknowledgements Introduction What Is a Difficult Decision? What Is This Book About Anyway? What Is Evidence-Based Medicine Really? Contents Contributors Abbreviations 1: Evidence-Based Medicine and the GRADE Approach Introduction Asking the Clinical Question Finding the Evidence Appraising the Studies The Grade System Features Increasing Quality of Observational Studies References Recommended Reading 2: Clinical Decision Analysis Introduction What Is Decision Analysis? Why Know About This? Anatomy of Clinical Decision Analysis Constructing the Decision Analytical Framework Determining Probabilities and Utility Values Calculating the Utility of Each Decision Management of an Incidentaloma Cost Effectiveness References 3: Decision-Making from the Surgeon’s Perspective Introduction The Clinical Recommendation Factors Influencing Surgeon Recommendations Application of Evidence Quality of Recommendations Shared Decision-Making Informed Consent Disclosure Understanding Process of Deciding Patient Factors Affecting Shared Decision-Making Surgeon Factors Affecting Shared Decision-Making Model for Ethical Decision-Making Special Situations in Decision-Making Genomic Issues Pediatric Patients Surrogate Decision-Making Unexpected Intraoperative Findings End-of-Life Issues Allocation of Resources References 4: Involving Patients in Difficult Decisions About Having Surgery What Is Shared Decision Making? Call for Shared Decision Making Meeting the Requirement of Informed Patients in SDM Impact of SDM on Clinical Outcomes The Need for SDM in Surgical Care Problems with SDM and Surgery Patient Clinical Complexity Difficulties in Patient Comprehension Surgical Practice The Way Forward Summary References 5: Surgery vs Active Surveillance for Low-Risk Papillary Thyroid Carcinoma Background The Evidence Base: Survival, Recurrence, and Progression of Disease The Evidence Base: PROs Including Quality of Life (QOL) The Evidence Base: Cost and Harm Discussion Recommendations References 6: Prospective Screening Protocol for FNMTC Family Members: Ultrasound Versus Physical Examination Overview of Familial Non-medullary Thyroid Cancer (FNMTC) Genetics of FNMTC Prognostic Differences in FNMTC Patients Screening for FNMTC Detection of the Abnormal Thyroid Defining the Population Most Likely to Benefit from Screening Understanding Risks with Numbers: Hypothetical Scenario of Patient Without Known Thyroid Disease Fine Needle Aspiration of Thyroid Nodules References 7: Operative Management Versus Observation for Thyroid Nodules Larger than 4 cm with Benign Cytology Introduction Methodology Results of Literature Review and Data Analysis Nodules Larger Than 4 cm Nodules Larger Than 3 cm Summary and Limitations Recommendations Personal View Abstracted Recommendation for Box References 8: Lobectomy Versus Total Thyroidectomy for Follicular Microcarcinomas Incidental Diagnosis of FTC Synchronous Distant Metastasis Surgical Treatment for FTC