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American Thyroid Association: Better communication among care team critical for optimal care, surveillance
Carty SE. Thyroid. 2011; [Published online ahead of print Dec. 9].
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Physicians who treat patients with thyroid cancer as part of a multidisciplinary treatment team need specific perioperative information, including results from clinical examination, biochemical testing, and cross-sectional and functional imaging tests, among other sources.
Communication between disciplines is critical, but the American Thyroid Association recognized that there was no universally accepted model for effectively sharing this data among the various care providers. The association’s Surgical Affairs Committee was tasked with identifying critical information that should be readily available to each member of the multidisciplinary team. The goal was to help physicians develop a management plan for each patient that will lead to a rational, risk-based approach to initial therapy, adjuvant therapy and follow-up studies.
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The committee identified three distinct types of data that must be shared: preoperative evaluations, intraoperative findings and postoperative data, events and plans. The committee provided several data points in each category such as comorbid conditions and abnormal laboratory values that could influence decisions about adjuvant radioiodine ablation therapy in the preoperative category, extent of surgery and description of gross extrathyroidal extension from the intraoperative findings and vocal cord dysfunction and anticipated after-care plan from the postoperative findings.
“Accurate communication of the important findings of thyroidectomy is critical to individualized risk stratification, as well as to the short-term follow-up issues of thyroid cancer care that are often jointly managed in the postoperative setting,” committee member R. Michael Tuttle, MD, of the Memorial Sloan-Kettering Cancer Center, and colleagues wrote. “Moreover, true multidisciplinary communication is essential to providing optimal adjuvant care and surveillance.”
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