{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:52:21Z","timestamp":1777877541288,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Several feasible management options exist for indeterminate thyroid nodules (ITNs), which can lead to decisional conflict (DC) and uncertainty in patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate patient and physician participation in shared decision-making (SDM) during the management of ITNs and the association of SDM with patient-perceived DC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Multi-institutional, cross-sectional, multiple methods study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The Queen Elizabeth II Health Science Centre (Halifax, Nova Scotia) from October 2020 to June 2023 and The Ottawa Hospital (Ottawa, Ontario) from November 2022 to June 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention and Exposures<\/jats:title>\n                    <jats:p>Patients with ITNs scheduled for an initial surgical consultation with an Otolaryngologist were included. Consultations were video-recorded using discreet cameras within clinic rooms at both sites. Management options discussed at both sites included repeat fine needle aspiration biopsy, ultrasound surveillance, surgery, and molecular testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Patient-perceived SDM was measured by the SDM Questionnaire-9 (SDM-Q-9) and perceived DC by the DC Scale (DCS). Surgeons\u2019 perceptions of SDM were measured by the SDM-Q-Doc. Observer-determined SDM was reported using the multifocal approach to sharing in SDM (MAPPIN\u2019SDM) instrument.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy-seven patients and 6 surgeons were included. Patient-perceived SDM was high [mean\u2009=\u200994.38, standard deviation (SD)\u2009=\u20097.61], while physician-perceived SDM was lower in comparison (mean\u2009=\u200983.21, SD\u2009=\u20099.14). Observer-determined SDM involvement of the patient (mean\u2009=\u20090.73, SD\u2009=\u20091.08), physician (mean\u2009=\u20091.71, SD\u2009=\u20091.33), and patient-physician dyad (mean\u2009=\u20091.75, SD\u2009=\u20091.27) was low. Clinically significant DC (DCS score \u226525) was reported by 13.2% of patients. There was a medium negative correlation between patient-perceived SDM involvement and DC (Pearson\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u2009\u22120.311,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.008). Patient-perceived SDM did not differ by clinicodemographic factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While patients and physicians perceived high levels of SDM, patients with ITNs are faced with difficult management decisions leading to DC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance<\/jats:title>\n                    <jats:p>These findings highlight the need for developing decision-aids to support SDM and reduce DC in the management of ITNs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251407670","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T09:46:05Z","timestamp":1767087965000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Shared Decision-Making During Surgical Consultations for Indeterminate Thyroid Nodules"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5710-583X","authenticated-orcid":false,"given":"Victoria","family":"Taylor","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Dalhousie University, Halifax, NS, Canada"},{"name":"Division of Otolaryngology\u2014Head &amp; Neck Surgery, Dalhousie University, Halifax, NS, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis","family":"Pickett","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brooke","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery, Western University, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Hermiston","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dalhousie University, Halifax, NS, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Azad","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery, University of Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2900-4626","authenticated-orcid":false,"given":"Matthew H.","family":"Rigby","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head &amp; Neck Surgery, Dalhousie University, Halifax, NS, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Johnson-Obaseki","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Corsten","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head &amp; Neck Surgery, Dalhousie University, Halifax, NS, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Forner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2008.09.019"},{"key":"e_1_3_2_3_2","unstructured":"International Agency for Research on Cancer (IARC). 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