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Laryngoscope. 2016 Nov;126(11):2640-2645. doi: 10.1002/lary.25986. Epub 2016 Apr 14.

Improving the adoption of thyroid cancer clinical practice guidelines.

Author information

1
Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Beth Israel, New York, New York.
2
Memorial Sloan Kettering Cancer Center, New York, New York.
3
Department of Otolaryngology - Head and Neck Surgery, Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York. ghaser@thancfoundation.org.
4
Department of Otolaryngology - Head and Neck Surgery, Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.
5
Division of Endocrinology, Diabetes and Bone Diseases, and the Division of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
6
Department of Otolaryngology - Head and Neck Surgery, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
7
Department of Endocrinology, Mayo Clinic Jacksonville, Jacksonville, Florida, U.S.A.
8
Department of Surgery, Boston University School of Medicine, Boston, Massachusetts, U.S.A.
9
Division of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, U.S.A.
10
Section of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston Medical Center, Boston, Massachusetts, U.S.A.
11
Thyroid & Endocrine Center of Florida, Florida State University College of Medicine, Sarasota, Florida, U.S.A.
12
Section of Endocrine Surgery, Department of Surgery, Banner-University Medical Center Phoenix, Phoenix, Arizona, U.S.A.
13
Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.
14
Department of Otolaryngology and the Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.
15
Department of Otolaryngology, Georgia Regents University, Augusta, Georgia, U.S.A.
16
Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.

Abstract

OBJECTIVES/HYPOTHESIS:

To present an overview of the barriers to the implementation of clinical practice guidelines (CPGs) in thyroid cancer management and to introduce a computer-based clinical support system.

DATA SOURCES:

PubMed.

REVIEW METHODS:

A review of studies on adherence to CPGs was conducted.

RESULTS:

Awareness and adoption of CPGs is low in thyroid cancer management. Barriers to implementation include unfamiliarity with the CPGs and financial concerns. Effective interventions to improve adherence are possible, especially when they are readily accessible at the point of care delivery. Computerized clinical support systems show particular promise. The authors introduce the clinical decision making modules (CDMMs) of the Thyroid Cancer Care Collaborative, a thyroid cancer-specific electronic health record. These computer-based modules can assist clinicians with implementation of these recommendations in clinical practice.

CONCLUSION:

Computer-based support systems can help clinicians understand and adopt the thyroid cancer CPGs. By integrating patient characteristics and guidelines at the point of care delivery, the CDMMs can improve adherence to the guidelines and help clinicians provide high-quality, evidence-based, and individualized patient care in the management of differentiated thyroid cancer. Laryngoscope, 126:2640-2645, 2016.

KEYWORDS:

Differentiated thyroid carcinoma; clinical decision making; clinical practice guidelines; computer-based support systems; thyroid nodules

PMID:
27074952
DOI:
10.1002/lary.25986
[Indexed for MEDLINE]

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