Faculty Collaboration Database

Composition and Priorities of Multidisciplinary Pediatric Thyroid Programs: A Consensus Statement. Thyroid 2025 Apr;35(4):346-356

Date

02/14/2025

Pubmed ID

39950999

DOI

10.1089/thy.2024.0496

Scopus ID

2-s2.0-85219661890 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

Background: The incidence of pediatric thyroid cancer has been increasing, and care varies due to socioeconomic disparities or differing practice patterns. Clinical guidelines call for care in multidisciplinary teams to minimize variance and provide protocols. Based on expert opinion, we hope to describe the form and function of such multidisciplinary teams for pediatric thyroid programs. Methods: A modified Delphi method to reach consensus statements over two rounds. Twenty-one experts with varying backgrounds responded to each statement on a 9-point Likert scale. Upon completion of the survey, the panel reviewed and shared the results and comments from participants and modified the statements accordingly. This process was repeated such that statements reached consensus, were deemed no consensus, or had no change in the mean. Results: There was an 88% and 83% completion rate for Rounds 1 and 2, respectively. A consensus was observed that there is a distinct definable model of care for pediatric thyroid patients. No consensus was reached for the age range of patients, but programs should care for children with medullary thyroid cancer, differentiated thyroid cancer, and patients with genetic predisposition syndromes. A comprehensive team includes, but is not limited to, a thyroid surgeon, a pediatric endocrinologist, a high-volume fine-needle aspiration (FNA) proceduralist, an oncologist, a nuclear medicine physician, a pediatric pathologist, a pediatric radiologist, and a nurse coordinator. Necessary support services involve care coordination, access to a multidisciplinary tumor board, ability to perform ultrasound-guided FNA, and access to molecular testing. The panel emphasized cross-institutional collaborative research prioritizing guidelines development, disease-specific outcomes, treatment toxicity, and the molecular landscape of thyroid cancer. Conclusions: These consensus statements can be beneficial in improving multidisciplinary care, by describing which elements of pediatric thyroid programs should be consistent across institutions. Overall, the panel agreed that pediatric thyroid centers should provide integrated care with defined team members, services, resources, and research priorities. This model has the potential to standardize various aspects of clinical care and enhance our ability to study patient outcomes, improve health care delivery, and increase scholarly collaboration.

Author List

Kothari R, Donner JR, Balakrishnan K, Hartman G, Pediatric Thyroid Program Workgroup:, Alazraki A, Antal Z, Bauer A, Chelius D, Cherella C, Dahl JP, Dimachkieh A, Fox LA, Helmig S, Jiang W, Kazahaya K, Laetsch TW, Lodish M, Mahajan P, Parsons L, Prickett K, Quintanilla-Dieck L, Rastatter J, Rothstein DH, Simons J, Sheyn A, Wagner A, Waguespack SG, Wasserman JD, Wassner AJ, Seeley H, Meister KD

Authors

Lauren Parsons MD Associate Professor in the Pathology and Laboratory Medicine department at Medical College of Wisconsin
Amy Wagner MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Delphi Technique
Humans
Patient Care Team
Pediatrics
Thyroid Gland
Thyroid Neoplasms