Improving the adoption of thyroid cancer clinical practice guidelines

Likhterov, Ilya; Tuttle, R. Michael; Haser, Grace C.; Su, Henry; Bergman, Donald A.; Alon, Eran E.; Bernet, Victor; Brett, Elise M.; Cobin, Rhoda H.; Dewey, Eliza H.; Doherty, Gerard M.; Reis, Laura L. Dos; Klopper, Joshua; Lee, Stephanie L.; Lupo, Mark A.; Macháč, Josef; Mechanick, Jeffrey I.; Milas, Mira; Orloff, Lisa A.; Randolph, Gregory W.; Ross, Douglas S.; Rowe, Meghan E.; Smallridge, Robert C.; Terris, David J.; Tufano, Ralph P.; Urken, Mark L.

doi:10.1002/lary.25986

Cited by 16 publications

(16 citation statements)

References 31 publications

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“…CPGs are intended to provide clinicians with actionable clinical recommendations based on the best current evidence [7]. The American Thyroid Association (ATA) provides CPGs that include specific recommendations for the aforementioned issues.…”

Section: Adherence To Cpgsmentioning

confidence: 99%

“…Currently in the USA, standardization in thyroid cancer management is suboptimal. There is a tremendous amount of variability between treatment sites and between physicians with respect to a multitude of thyroid care decisions: the use of radioactive iodine therapy; the offering of active surveillance for patients with low risk cancers; the decision to biopsy patients with nodules that are low risk or less than a centimeter in size; and the extent of thyroid surgery and the interpretation of risk factors, such as the presence of positive central compartment lymph nodes [7].CPGs are intended to provide clinicians with actionable clinical recommendations based on the best current evidence [7]. The American Thyroid Association (ATA) provides CPGs that include specific recommendations for the aforementioned issues.…”

mentioning

confidence: 99%

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Thyroid Care Collaborative: An Electronic Health Record Facilitating Multidisciplinary Management of Thyroid Cancer

Kiplagat

Griffin

Baik

et al. 2018

Int. J. Endo. Oncol.

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" As a patient-based, disease-specific EHR, the TCC connects all physicians involved in a patient's care by giving them direct access to the most up-to-date records, once the patient invites them to participate in the TCC. This innovative approach puts the patient at the center, and allows physicians in the care team to communicate regardless of hospital affiliation. " In the 1990s, the concept of the electronic health record (EHR) was established to support, maintain and improve the quality of our healthcare system [1]. Since its advent, the content, structure and technology of an EHR has evolved over time, however, the goals of the EHR have remained relatively steadfast [1]. EHRs aim to improve quality of care by increasing the accessibility and comprehensiveness of health information, providing portability of health records, enhancing connectivity between physicians involved in the care of a patient, encouraging patient engagement and facilitating multidisciplinary care management. However, EHRs may serve a variety of purposes aside from patient care, such as achieving certain levels of documentation to support levels of billing for encounters. The latter often leads to the entry of endless details that are not truly relevant to a patient's disease, making it difficult and cumbersome to decipher the specific information required to provide quality care. Specialization of web-based health-record systems have led to disease-specific databases, such as the Thyroid Care Collaborative (TCC), formerly known as the Thyroid Cancer Care Collaborative. The TCC is a thyroidspecific database that can be easily integrated into the physician workflow to improve the quality of care delivered to patients with thyroid nodules and thyroid cancer. Web-based disease-specific electronic records, such as the TCC, are dynamic and can be readily modified as new information becomes available. The following examples demonstrate the importance of this feature: the ability to add new data points such as genetic mutations that are found to influence disease virulence and patient outcomes, such as the TERT mutation; and the ability to change disease staging based on AJCC modifications or refinement of the American Thyroid Association's risk of recurrence stratification [2,3]. As new disease-specific information becomes available, the web-based EHR can evolve accordingly. The successful treatment and surveillance of thyroid cancer does not start and end with one surgeon or one endocrinologist, but rather most patients are treated in a collaborative and multidisciplinary fashion. Often those providers involved in the care of a particular patient are not in the same institution and commonly do not use the same EHR. In this paper, we will review how the TCC improves the multidisciplinary management of thyroid cancer by: enhancing communication between physicians; providing a platform for active surveillance in patients with low-risk thyroid cancers; establishing electronic feedback loops that inform the providers as to the results of further ...

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Section: Adherence To Cpgsmentioning

confidence: 99%

mentioning

confidence: 99%

Thyroid Care Collaborative: An Electronic Health Record Facilitating Multidisciplinary Management of Thyroid Cancer

Kiplagat

Griffin

Baik

et al. 2018

Int. J. Endo. Oncol.

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show abstract

“…By including modules for reporting ultrasound, cytology, and thyroid cancer management (i.e., surgery, pathology, nuclear medicine, and posttreatment surveillance), the TCC delivers a convenient platform for an interdisciplinary team of clinicians to collaborate, educate, and remain informed throughout a patient's entire thyroid nodule/cancer journey. Through the delivery of clinical practice guidelines directly to the point of care, the TCC helps to ensure that physicians are making the most evidence‐based management decisions …”

Section: Introductionmentioning

confidence: 99%

“…Through the delivery of clinical practice guidelines directly to the point of care, the TCC helps to ensure that physicians are making the most evidence-based management decisions. 4 This approach to patient care encourages a clinician to reconcile discordant information whenever a result or therapeutic intervention contradicts the accumulated information about that patient to date. The process of reconciliation demands a level of discipline in patient care but promises to enhance the quality of care in a thyroid patient's journey from workup to treatment, and ultimately to surveillance.…”

Section: Introductionmentioning

confidence: 99%

Enhanced interdisciplinary communication: development of an interactive thyroid nodule/cancer disease map

et al. 2018

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The main advantages of this disease-specific, dynamic, three-dimensional, anatomic disease map are: 1) portability across institutions and disciplines, 2) disease specificity to thyroid nodule and cancer care, and 3) ability to trigger more detailed evaluation or reconciliation of any change in a patient's status regarding the nature or the extent of a patient's disease. The first and second advantages above have been identified as areas representing opportunities for quality improvement in health informatics research. Laryngoscope, 2018.

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“…There were 62,980 estimated new cases of thyroid cancer in the United States in 2014, as well as 1,890 cancer-associated mortalities (2). The frequency of ATC is increasing, and it currently accounts for 2.5% of all cancers in the United States (3).…”

Section: Introductionmentioning

confidence: 99%

p21 participates in the regulation of anaplastic thyroid cancer cell proliferation by miR-146b

Wang¹,

Chen²,

Bai³

2016

Oncology Letters

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Abstract. Anaplastic thyroid carcinoma (ATC) originates from completely undifferentiated cells, and is the most lethal type of thyroid-derived tumor. Numerous microRNAs have significant roles in tumorigenesis by targeting relevant genes. The role of microRNA 146b (miR-146b) in ATC remains to be elucidated. In order to characterize the role of miR-146b in ATC, overexpression or interference of miR-146b was induced in ATC cell lines, and cell proliferation and migration were evaluated. The potential targets of miR-146b were searched in the Gene Expression Omnibus database for ATC and matched non-tumor control samples. The expression level of potential targets was detected following overexpression or interference of miR-146b in ATC cell lines. In the present study, cell proliferation was promoted when overexpression of miR-146b was induced in ATC, and inhibited when interference of miR-146b was induced, which indicated that miR-146b affects the proliferation of ATC cells in vitro. In addition, cell migration of ATC was also affected by miR-146b. During the search for potential targets of miR-146b in ATC, p21 (also known as p21 Waf1/Cip1 or CDKN1A) was noted for its role in cell cycle progression and tumor pathogenesis. The expression level of p21 was influenced by the level of miR-146b, and the results of the present study demonstrated that the level of p21 was increased when FRO cells were transformed with miR-146b mimic, and p21 was downregulated when FRO cells transformed with anti-miR-146b. In conclusion, p21 may participate in the regulation of ATC cell proliferation by miR-146b.

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Improving the adoption of thyroid cancer clinical practice guidelines

Cited by 16 publications

References 31 publications

Thyroid Care Collaborative: An Electronic Health Record Facilitating Multidisciplinary Management of Thyroid Cancer

Thyroid Care Collaborative: An Electronic Health Record Facilitating Multidisciplinary Management of Thyroid Cancer

Enhanced interdisciplinary communication: development of an interactive thyroid nodule/cancer disease map

p21 participates in the regulation of anaplastic thyroid cancer cell proliferation by miR-146b

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