ThyroidDevelopment of the ThyCAT: A clinically useful computerized adaptive test to assess quality of life in thyroid cancer survivors
Section snippets
The bifactor model
Quality of life is a multidimensional phenomenon; the metric utilized in the NATCSS survey, for instance, samples quality of life items from physical, psychologic, social, and spiritual domains. Items sampled from the subdomains produce residual associations between items within the subdomains unaccounted for in the primary dimension (here, quality of life) on which most applications of item response theory and unidimensional models are based.14, 15 Bifactor item response theory models permit
Bifactor model
The fit of the bifactor model to the observed data is illustrated in Fig. Fig reveals strong agreement between the item-category proportions based on the model and the observed data (r = 0.963). Of the original 75 items in the QOL survey, 58 items were selected for the CAT item bank based on the 0.35 primary factor loading criterion (Table II). The items included in each subdomain are illustrated there as well, with the largest number of questions (N = 29) belonging to the physical subdomain,
Discussion
Although thyroid cancer prognoses are good (the 10-year survival for the predominant type, papillary, is as high as 97%), the initial findings of the NATCSS study point to long-term and late psychosocial effects after completion of primary treatment requiring coordinated follow-up.3 The surprise of these findings suggesting QoL comparable with cancers of much poorer prognosis4 illustrates how poorly understood long-term thyroid cancer survivorship currently is. This problem will continue to
Acknowledgments
Study data were collected and managed using REDCap electronic data capture tools hosted at The University of Chicago. REDCap (Research Electronic Data Capture) is a secure, Web-based application designed to support data capture for research studies, providing (1) an intuitive interface for validated data entry; (2) audit trails for tracking data manipulation and export procedures; (3) automated export procedures for seamless data downloads to common statistical packages; and (4) procedures for
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Quality of life in thyroid cancer
2023, Best Practice and Research: Clinical Endocrinology and MetabolismChanges in total thyroidectomy versus thyroid lobectomy for papillary thyroid cancer during the past 15 years
2019, Surgery (United States)Citation Excerpt :However, the use of radioactive iodine has not been substantiated in small, nonaggressive PTCs.27–30 Along with the considerable data showing equivalency in outcomes with less aggressive surgery, there have also been several studies showing significant quality of life effects associated with the treatment of thyroid cancer, primarily thyroidectomy and radioiodine ablation, suggesting a true detrimental effect of overtreating these less aggressive thyroid cancers.15,16,31–33 As a result of the growing body of literature suggesting overdiagnosis and overtreatment of nonaggressive PTCs, a substantial shift in the recommendations for the surgical treatment have occurred during the past 12 years.
Quality of Life in Head & Neck Surgical Oncology and Thyroid Surgery
2023, Patient Reported Outcomes and Quality of Life in SurgeryThyroid disease-specific quality of life questionnaires - A systematic review
2022, Endocrinology, Diabetes and MetabolismLooking under the hood of “the Cadillac of cancers:” radioactive iodine-related craniofacial side effects among patients with thyroid cancer
2020, Journal of Cancer Survivorship
Supported by the National Institutes of Health for A New Statistical Paradigm for Measuring Psychopathology Dimensions in Youth (Grant #: 1R01MH100155-01).
Raymon H. Grogan, MD, was supported in part by the University of Chicago Bucksbaum Institute for Clinical Excellence.
Robert Gibbons, PhD, is a founder of Adaptive Testing Technologies, a company that distributes computerized adaptive tests. The terms of this arrangement have been reviewed and approved by the University of Chicago in accordance with its conflict of interest policies. The other authors reported no biomedical financial interests or potential conflicts of interest.
Presented at the 38th Annual Meeting of the American Association of Endocrine Surgeons, Orlando, FL, April 2–4, 2017.