{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:15:39Z","timestamp":1793124939394,"version":"4.5.0"},"reference-count":53,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"Importance<\/jats:title>Counseling prior to thyroid cancer (TC) treatment is an essential component of informed consent. An informed patient affects treatment-related expectations and patient engagement, factors that contribute significantly to patient-reported quality-of-life outcomes.<\/jats:p><\/jats:sec>Objective<\/jats:title>To describe experiences with pretreatment counseling among survivors of TC and to test factors associated with self-reported treatment meeting expectations.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>A cross-sectional survey was administered between October 18, 2019, and February 8, 2020, to members of ThyCa: Thyroid Cancer Survivors\u2019 Association Inc, and to individuals accessing the public-facing ThyCa website. Survey respondents were asked 55 questions, including 4 free-text questions and 2 multiple-choice questions about pretreatment counseling.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Respondents self-reported (1) their unmet information needs, (2) rates of treatment meeting expectations, and (3) rates of treatment understanding. A mixed-methods analysis was performed, including qualitative content analysis of free-text responses and multivariable logistic regression of factors associated with self-reported levels of treatment meeting expectations.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 1412 survey respondents, 1249 were women (88.4%). The median age at diagnosis was 48 years (range, 18-85 years), and the median age at the time of survey completion was 60 years (range, 18-87 years). A total of 1259 respondents (89.2%) provided free-text responses to the question, \u201cWhat would you tell someone newly diagnosed with your same condition?\u201d Of these individuals, 526 (37.2%) reported inadequate pretreatment plan understanding and 578 (40.9%) reported that their treatment experience did not meet their expectations. Treatment met expectations for only 95 respondents (18.1%) reporting an inadequate pretreatment plan understanding. Of the 526 survivors of TC reporting a lack of understanding, 473 (90.0%) provided additional textual comments, most commonly in the categories of postoperative treatment, surveillance, and treatment effects. On multivariable logistic regression, self-reported failure to have an understanding of TC treatment was independently associated with failure of treatment to meet expectations (odds ratio, 5.1 [95% CI, 3.7-6.9]). Patients reporting a full understanding of their treatment plan were 5-fold more likely to indicate that their initial treatment experience was on par with expectations, independent of reported postoperative complications, age, sex, and other potential confounders.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this survey study, a substantial proportion of survivors of TC reported inadequate pretreatment understanding. This gap in understanding was associated with high levels of self-reported failure of treatment to meet expectations, which in turn is associated in other studies with poorer patient-reported quality-of-life outcomes. These outcomes may be improved by addressing gaps in patient understanding so expectations more closely match TC diagnosis and treatment pathways.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2022.4108","type":"journal-article","created":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T16:32:58Z","timestamp":1672331578000},"page":"110","source":"Crossref","is-referenced-by-count":28,"title":["Analysis of Unmet Information Needs Among Patients With Thyroid Cancer"],"prefix":"10.1001","volume":"149","author":[{"given":"Amanda Silver","family":"Karcioglu","sequence":"first","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston"},{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, NorthShore University HealthSystem, Evanston, Illinois"},{"name":"Pritzker School of Medicine, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaninder 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