Regional differences in opinions on adjuvant radioactive iodine treatment of thyroid carcinoma within Canada and the United States

被引：15
作者：
Sawka, Anna M. [1 ,2 ,3 ,4 ]
Rotstein, Lorne [5 ,6 ]
Brierley, James D. [7 ,8 ]
Tsang, Richard W. [7 ,8 ]
Thabane, Lehana [9 ,10 ]
Gafni, Amiram [9 ,11 ]
Straus, Sharon [12 ,13 ,14 ]
Kamalanathan, Shamila [15 ]
Zhao, Boyu [15 ]
Goldstein, David P. [16 ,17 ]
Rambaldini, Gloria [18 ]
Ezzat, Shereen [3 ,4 ,19 ,20 ,21 ,22 ]
机构：
[1] Univ Hlth Network, Div Endocrinol, Toronto, ON, Canada
[2] Univ Hlth Network, Dept Med, Toronto, ON, Canada
[3] Univ Toronto, Div Endocrinol, Toronto, ON, Canada
[4] Univ Toronto, Dept Med, Toronto, ON, Canada
[5] Univ Hlth Network, Dept Surg, Toronto, ON, Canada
[6] Univ Toronto, Dept Surg, Toronto, ON, Canada
[7] Univ Hlth Network, Dept Radiat Oncol, Toronto, ON, Canada
[8] Univ Toronto, Dept Radiat Oncol, Toronto, ON, Canada
[9] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
[10] St Josephs Healthcare, Ctr Evaluat Med, Hamilton, ON, Canada
[11] McMaster Univ, Ctr Hlth Econ & Policy Analy, Hamilton, ON, Canada
[12] Univ Toronto, Dept Knowledge Translat, Toronto, ON, Canada
[13] Univ Calgary, Div Geriatr, Calgary, AB, Canada
[14] Univ Calgary, Dept Med, Calgary, AB, Canada
[15] Univ Hlth Network, Dept Med, Div Endocrinol, Toronto, ON, Canada
[16] Univ Hlth Network, Dept Otolaryngol Head & Neck Surg, Toronto, ON, Canada
[17] Univ Toronto, Toronto, ON, Canada
[18] York Cent Hosp, Dept Med, Richmond Hill, ON, Canada
[19] Mt Sinai Hosp, Div Endocrinol, Toronto, ON M5G 1X5, Canada
[20] Mt Sinai Hosp, Dept Med, Toronto, ON M5G 1X5, Canada
[21] Freeman Ctr Endocrine Oncol, Toronto, ON, Canada
[22] Ontario Canc Inst, Toronto, ON M4X 1K9, Canada
来源：
THYROID | 2007年 / 17卷 / 12期
关键词：
D O I：
10.1089/thy.2007.0077
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Objective: To identify regional differences in recommendations for radioactive iodine remnant ablation (RRA) in early stage well-differentiated thyroid carcinoma (WDTC) within Canada and the United States. Design: A cross-sectional written survey of a sample of physicians in specialties potentially involved in thyroid cancer care was performed in 2006. Participants were asked if they recommended RRA for a hypothetical 38-year-old woman with a solitary, 1.6-cm papillary carcinoma resected by total thyroidectomy. Exploratory regional comparisons were performed using Student t tests or analysis of variance. The regions studied were western Canada, eastern Canada (Ontario, the Maritimes), Quebec, the northeastern United States, the western and midwestern United States, and the southern United States. In a secondary multivariable logistic regression analysis, we explored potential relationships between individual respondent characteristics RRA recommendations. Main outcome: Agreement with case-based RRA recommendations was measured on a Likert scale of 1 to 7 (7 = strongest agreement). Results: The effective response rate was 56.3% (486/864). There were significant differences in RRA recommendations among the regions studied (F = 11.99, 5 df, p < 0.001); national boundaries did not explain regional variations. For the sample case, the strongest support for RRA was in Quebec and the southern United States, intermediate support in eastern Canada and the northeastern United States, and the least support in western Canada and the western and midwestern United States. Academic affiliation and surgical specialty were independently inversely associated with strong RRA recommendations. Conclusions: There are significant regional differences in physician-based RRA recommendations in early stage WDTC within Canada and the United States. Physician specialty and practice characteristics may influence RRA recommendations.
引用
收藏
页码：1235 / 1242
页数：8
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