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It can be a disquieting moment for a patient. A lump or bump is found on their neck. It鈥檚 a thyroid nodule. Is it cancer? Many of those patients will probably want to get a biopsy as soon as they can.

The number of people diagnosed with thyroid cancer has tripled in the last 40 years as imaging technology has become more common and nodules are often discovered incidentally in patients without symptoms.

While biopsy makes sense for some patients, physicians note, it isn鈥檛 the best option for all.

A University of Florida 网红黑料 researcher is leading a team developing a conversation aid to be used during what can be a challenging clinical encounter when it鈥檚 crucial for a doctor to clearly and completely communicate a patient鈥檚 cancer risk and management options.

One of the goals is to ensure the patient understands that a biopsy or surgery, which each carry risk of complication, are often unnecessary when nonsuspicious thyroid nodules can be safely monitored over time with ultrasound. Many nodules pose no danger.

, M.D., an associate professor in the 鈥檚 , said one of the hopes is that a patient will arrive at a medical decision on either a biopsy or ultrasound follow up that will be the best for their particular situation.

鈥淭he clinicians are basically facing this conundrum,鈥� said Singh Ospina, who also is a faculty member in the . 鈥淒o you order biopsies in a very liberal sort of way and risk all the problems related to thyroid cancer overdiagnosis and overtreatment?

鈥淥n the other hand,鈥� she added, 鈥渋f you are too strict selecting patients for biopsy, there will be a concern that we might miss a clinically relevant thyroid cancer.鈥�

The conversation aid, displayed on a computer screen, will help clinicians and their patients together navigate that difficult terrain.

鈥淭he whole idea is to make this conversation flow better and allow the patient and clinician to discuss all the sensitive and important topics so they can decide, 鈥極kay, what鈥檚 best for me, a biopsy or ultrasound monitoring?鈥欌�� Singh Ospina said. 鈥淲e want to make the clinical encounter more personalized to the patient鈥檚 needs.鈥�

The conversation aid, she said, seeks to ensure 鈥渢he decisions that are made are more congruent with the patient鈥檚 own beliefs, values and the clinical evidence.鈥�

A prototype conversation aid Singh Ospina and her team have developed starts by providing general information about the thyroid gland. It goes on to categorize the patient鈥檚 thyroid nodule, its features and explains the risk of thyroid cancer, ranging from very low to high.

鈥淭hen the conversation aid gives you options based on those risks and provides the good and bad things about each,鈥� she said. 鈥淚t supports the conversation between patients and clinicians and seeks to elicit the patients鈥� thoughts about their situation and options.鈥�

The aid outlines management options, the risks for each path and what each option means.

For example, the conversation aid tells a patient ultrasound monitoring should be completed every six to 24 months, depending on their risk.

Patients are walked through the potential downside of each possible choice. Removing a nodule, for example, will leave a small neck scar and could lead to complications affecting the voice.

Singh Ospina recently completed an that found the prototype conversation aid her group developed was associated with increased patient involvement in the decision-making process and improved clinician satisfaction and led to a fuller discussion.

Singh Ospina and colleagues are planning a randomized trial to see if a conversation aid is beneficial in a larger group of patients.

鈥淭he decision on whether to move forward with a thyroid biopsy or ultrasound monitoring is an important decision,鈥� she said. 鈥淲e want to support conversations and collaboration between patients and clinicians to assure they feel comfortable and confident in the path that they choose. This requires a good understanding of the clinical evidence and the patient鈥檚 situation.鈥�