ThyroidEx: Development and preliminary validation of a thyroid surgery expectations measure Journal Article


Authors: Patel, S. G.; Atkinson, T. M.; Tuttle, R. M.; Pusic, A. L.; Shah, J. P.; Shaha, A. R.; Lynch, K.; DiLorenzo, M.; Ali, S.; Wong, R. J.; Cracchiolo, J. R.
Article Title: ThyroidEx: Development and preliminary validation of a thyroid surgery expectations measure
Abstract: Objective: To address the lack of validated patient-reported outcome (PRO) instruments that define and quantify patient expectations in thyroid cancer surgery, we developed and initially validated ThyroidEx, a novel disease-specific PRO instrument. Study Design: Survey study. Setting: Single-institution tertiary care cancer center. Methods: An expert panel drafted an initial set of thyroid cancer–specific concepts, which was used in semistructured concept elicitation interviews with patients with thyroid cancer 4 weeks before and 8 weeks after surgery. Candidate items were generated per patient responses and refined via cognitive interviewing and additional review by the expert panel. The draft ThyroidEx was then preoperatively administered to a separate cohort undergoing thyroid cancer surgery to establish a final item set and initial psychometric evidence. Results: Prospective concept elicitation interviews generated 358 patient-elicited concepts (n = 15 patients). These were then placed into 70 unique subcategories from which 41 items were generated for cognitive interviews with 20 patients preoperatively and 28 postoperatively. After expert panel review, ThyroidEx included 18 items across 2 scales (Expectations and Concerns), with an additional item about beliefs. In the preoperative cohort in phase 2 (n = 67), internal consistency Cronbach’s α values ranged from 0.81 to 0.89. Descriptive analysis showed significant differences between patients’ concerns and expectations and clinicians’ perceptions. Conclusion: Defining expectations represents an important modifier in the measurement of PROs. Preliminary validation of ThyroidEx revealed incongruent expectations between expert opinion and patients. Future development and implementation of ThyroidEx may affect preoperative consultation and the consent process. © American Academy of Otolaryngology–Head and Neck Surgery Foundation 2020.
Keywords: adult; human tissue; major clinical study; metabolism; data analysis; thyroidectomy; expectation; interview; cross-sectional study; thyroid cancer; health-related quality of life; patient-reported outcomes; thyroid surgery; quality improvement; subtotal thyroidectomy; patient-reported outcome; expectations; human; male; female; article
Journal Title: Otolaryngology - Head and Neck Surgery
Volume: 165
Issue: 2
ISSN: 0194-5998
Publisher: Sage Publications  
Date Published: 2021-08-01
Start Page: 267
End Page: 274
Language: English
DOI: 10.1177/0194599820976317
PUBMED: 33320788
PROVIDER: scopus
PMCID: PMC8203758
DOI/URL:
Notes: Article -- Export Date: 1 September 2021 -- Source: Scopus
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  1. Ashok R Shaha
    698 Shaha
  2. Snehal G Patel
    412 Patel
  3. Robert M Tuttle
    482 Tuttle
  4. Richard J Wong
    415 Wong
  5. Thomas Michael Atkinson
    155 Atkinson
  6. Jatin P Shah
    721 Shah
  7. Kathleen A Lynch
    71 Lynch