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Among 77 patients and 6 surgeons, patient-perceived shared decision-making was high, yet observer-determined involvement was low, and 13.2% reported clinically significant conflict. Greater perceived involvement correlated with lower conflict.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/shared-decision-making-during-surgical-consultations-for-indeterminate-thyroid-nodules/406161/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/shared-decision-making-during-surgical-consultations-for-indeterminate-thyroid-nodules/406161.png","ImageObject",300,407,{"name":42,"@type":43},"Taylor Morgan","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the study investigating about indeterminate thyroid nodules?","Question",{"text":63,"@type":64},"The study investigates patient and physician participation in shared decision-making during surgical consultations for indeterminate thyroid nodules and examines how shared decision-making relates to patient-perceived decisional conflict.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were shared decision-making and decisional conflict measured?",{"text":68,"@type":64},"Patient-perceived shared decision-making was measured using the SDM Questionnaire-9 (SDM-Q-9), while perceived decisional conflict was measured using the DC Scale (DCS). Surgeons’ perceptions used SDM-Q-Doc, and observer-determined shared decision-making used the MAPPIN’SDM instrument.",{"name":70,"@type":61,"acceptedAnswer":71},"What were the main findings regarding shared decision-making and decisional conflict?",{"text":72,"@type":64},"Patient-perceived shared decision-making was high, but objective/observer-determined involvement was low. Clinically significant decisional conflict occurred in 13.2% of patients, and higher patient-perceived shared decision-making involvement showed a medium negative correlation with decisional conflict.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},406161,1790791794,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":55,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},1099523885336,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Shared Decision-Making During Surgical Consultations for Indeterminate Thyroid Nodules  \nVictoria Taylor, MD 1 ,2, Travis Pickett, MD3, Brooke Turner, MD4, Claire Hermiston, MD 1 , Tara Azad, MSc3, David P. Goldstein, MD, MSc5, Matthew H. Rigby, MD, MPH2, Stephanie Johnson-Obaseki, MD, MPH3, Martin Corsten, MD2*, and David Forner, MD, MSc6*  \nJournal of Otolaryngology-Head & Neck Surgery  \nVolume 54: 1–9  \n© The Author(s) 2025  \nArticle reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/19160216251407670](DOI: 10.1177/19160216251407670)[ ](DOI: 10.1177/19160216251407670)[journals.sagepub.com/home/ohn](journals.sagepub.com/home/ohn)  \nAbstract  \nImportance. Several feasible management options exist for indeterminate thyroid nodules (ITNs), which can lead to decisional conflict (DC) and uncertainty in patients.  \nObjective. To investigate patient and physician participation in shared decision-making (SDM) during the management of ITNsand the association of SDM with patient-perceived DC.  \nStudy Design. Multi-institutional, cross-sectional, multiple methods study.  \nSetting. 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.  \nIntervention and Exposures. 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.  \nMain Outcome Measures. Patient-perceived SDM was measured by the SDM Questionnaire-9 (SDM-Q-9) and perceived DC by the DC Scale (DCS). Surgeons’ perceptions of SDM were measured by the SDM-Q-Doc. Observer-determined SDM was reported using the multifocal approach to sharing in SDM (MAPPIN’SDM) instrument.  \nResults. Seventy-seven patients and 6 surgeons were included. Patient-perceived SDM was high [mean = 94.38, standard deviation (SD) = 7.61], while physician-perceived SDM was lower in comparison (mean = 83.21, SD = 9.14). Observer-determined SDM involvement of the patient (mean = 0.73, SD = 1.08), physician (mean = 1.71, SD = 1.33), and patient-physician dyad (mean = 1.75, SD = 1.27) was low. Clinically significant DC (DCS score ≥25) was reported by 13.2% of patients. There was a medium negative correlation between patient-perceived SDM involvement and DC (Pearson r = −0.311, P = 0.008). Patient-perceived SDM did not differ by clinicodemographic factors.  \nConclusion. While patients and physicians perceived high levels of SDM, patients with ITNs are faced with difficult management decisions leading to DC.  \nRelevance. These findings highlight the need for developing decision-aids to support SDM and reduce DC in the management of ITNs.  \nKeywords  \nthyroid nodule, thyroid, Bethesda, cytology, FNA, shared decision-making  \nReceived April 24, 2025; accepted October 28, 2025.  \nCreative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial  \n4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ([https://us.sagepub.com/en-us/nam/open-access-at-sage](https://us.sagepub.com/en-us/nam/open-access-at-sage)).  \nGraphical Abstract  \n1 Faculty of Medicine, Dalhousie University, Halifax, NS, Canada  \n2Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS, Canada 3Department of Otolaryngology—Head & Neck Surgery, University of Ottawa, Ottawa, ON, Canada 4Department of Otolaryngology—Head & Neck Surger","cbCairJZ8hzwlpnj","https://ap.wps.com/l/cbCairJZ8hzwlpnj","pdf",917466,"English","# Abstract\n## Importance and Objective\n## Study Design and Setting\n## Intervention and Outcome Measures\n## Results\n## Conclusion and Relevance\n# Key Messages\n# Introduction","[{\"question\":\"What is the study investigating about indeterminate thyroid nodules?\",\"answer\":\"The study investigates patient and physician participation in shared decision-making during surgical consultations for indeterminate thyroid nodules and examines how shared decision-making relates to patient-perceived decisional conflict.\"},{\"question\":\"How were shared decision-making and decisional conflict measured?\",\"answer\":\"Patient-perceived shared decision-making was measured using the SDM Questionnaire-9 (SDM-Q-9), while perceived decisional conflict was measured using the DC Scale (DCS). Surgeons’ perceptions used SDM-Q-Doc, and observer-determined shared decision-making used the MAPPIN’SDM instrument.\"},{\"question\":\"What were the main findings regarding shared decision-making and decisional conflict?\",\"answer\":\"Patient-perceived shared decision-making was high, but objective/observer-determined involvement was low. Clinically significant decisional conflict occurred in 13.2% of patients, and higher patient-perceived shared decision-making involvement showed a medium negative correlation with decisional conflict.\"}]","Shared Decision-Making During Surgical Consultations for Indeterminate Thyroid Nodules | PDF",1790563877,23]