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Quality of Life in Patients with Benign Non-Toxic Goiter After Surgical Intervention: A Systematic Review and Meta-Analysis

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Abstract

Background

Prior studies evaluating health-related quality of life (HR-QoL) outcomes in patients undergoing surgery for benign non-toxic goiter have used different instruments and time points, leading to conflicting results. We sought to systematically review the differences in HR-QoL among patients with BNTG at baseline and 6 months after surgery, using exclusively the ThyPRO questionnaire.

Methods

A systematic search was performed using PubMed, Embase, Web of Science, Cochrane Central, CINAHL, and PsycINFO for papers reporting the assessment of HR-QoL utilizing ThyPRO. Data were meta-analyzed using a random-effects model, and pooled estimates were calculated using weighted mean differences (WMD) between baseline and 6 months after surgery. We assessed the quality and risk of bias of the studies using the Robins-I tool and previously published minimally important change (MIC) values to assess clinical significance.

Results

Six papers met the predefined inclusion criteria, describing a total of 496 patients. Meta-analysis demonstrated improved QoL in all thirteen domains of ThyPRO six months post-surgical intervention compared to baseline. Specifically, the largest improvement in QoL was seen in the domains of overall QoL, WMD −25.84 (95% CI −29.70, −21.98, p < 0.001, I2 = 23%), goiter symptoms, 23.96 (95% CI −30.29, −17.64, p < 0.001, I2 = 91%), and tiredness, −16.20 (95% CI −19.23, −13.16, p < 0.001, I2 = 3%). The differences in scores 9 of 13 domains were clinically significant based on MIC.

Conclusions

Disease-specific HR-QoL improved in all ThyPRO domains after surgery in patients with BNTG. Future studies of QoL in thyroid surgery patients will benefit from a standard questionnaire and improved reporting of covariates including complications to ensure comparability across studies.

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Authors and Affiliations

  1. Harvard Medical School, Boston, MA, USA

    M. Juanita Rodriguez, Jordan M. Broekhuis & Benjamin C. James

  2. Section of Endocrine Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 605, Boston, MA, 02215, USA

    Natalia Chaves, M. Juanita Rodriguez, Jordan M. Broekhuis, Hao Wei Chen & Benjamin C. James

  3. Countway Library, Harvard Medical School, Boston, MA, USA

    Paul A. Bain

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Appendix 1. Database searches

Appendix 1. Database searches

PubMed (NCBI).

March 16, 2021.

475 Records.

("Goiter/surgery"[mesh] OR (("Goiter"[mesh] OR goiter*[tiab] OR goitre*:ab,ti,kw) AND.

("Thyroidectomy"[mesh] OR surgery[sh] OR thyroidectom*[tiab] OR strumecto*[tiab] OR.

lobectom*[tiab] OR surgery[tiab] OR surgical[tiab] OR operative[tiab]))).

AND

("Quality of Life"[mesh] OR "Patient Satisfaction"[mesh] OR "Patient Reported Outcome.

Measures"[mesh] OR "Surveys and Questionnaires"[mesh] OR quality of life[tiab] OR qol[tiab].

OR HRQoL[tiab] OR satisfaction[tiab] OR thypro*[tiab] OR patient reported outcome*[tiab] OR.

prom[tiab] OR proms[tiab] OR survey*[tiab] OR questionnaire*[tiab]).

Embase (Elsevier; 1974-).

March 16, 2021.

328 Records.

(('goiter'/exp AND 'thyroidectomy'/exp) OR ((goiter*:ab,ti,kw OR goitre*:ab,ti,kw) AND.

(thyroidectom*:ab,ti,kw OR strumecto*:ab,ti,kw OR lobectom*:ab,ti,kw OR surgery:ab,ti,kw.

OR surgical:ab,ti,kw OR operative:ab,ti,kw))).

AND

('quality of life'/exp OR 'patient satisfaction'/exp OR 'patient-reported outcome'/exp OR 'patient.

reported outcome measure'/exp OR 'questionnaire'/exp OR 'survey'/exp OR ('quality of life' OR.

qol OR hrqol OR satisfaction OR thypro* OR 'patient reported outcome*' OR prom OR proms.

OR survey* OR questionnaire*):ab,ti,kw).

Web of Science Core Collection (Clarivate Analytics).

March 16, 2021.

190 Records.

TS = (("goiter*" OR "goitre*") AND ("thyroidectom*" OR "strumecto*" OR "lobectom*" OR.

"surgery" OR "surgical" OR "operative")).

AND

TS = ("quality of life" OR "qol" OR "hrqol" OR "satisfaction" OR "thypro*" OR "patient reported.

outcome*" OR "prom" OR "proms" OR "survey*" OR "questionnaire*").

Cochrane Central Register of Controlled Trials (Wiley).

March 16, 2021.

26 Records

(("goiter*" OR "goitre*") AND ("thyroidectom*" OR "strumecto*" OR "lobectom*" OR.

"surgery" OR "surgical" OR "operative")).

AND

("quality of life" OR "qol" OR "hrqol" OR "satisfaction" OR "thypro*" OR "patient reported.

outcome*" OR "prom" OR "proms" OR "survey*" OR "questionnaire*").

CINAHL (EBSCO)

March 16, 2021.

35 Records

(MH ("Goiter/SU" OR ("Goiter" AND "Thyroidectomy")) OR TI (("goiter*" OR "goitre*").

AND ("thyroidectom*" OR "strumecto*" OR "lobectom*" OR "surgery" OR "surgical" OR.

"operative")) OR AB (("goiter*" OR "goitre*") AND ("thyroidectom*" OR "strumecto*" OR.

"lobectom*" OR "surgery" OR "surgical" OR "operative"))).

AND

(MH ("Quality of Life" OR "Patient Satisfaction" OR "Patient Reported Outcomes" OR.

"Surveys" OR "Questionnaires") OR TI ("quality of life" OR "qol" OR "hrqol" OR "satisfaction"

OR "thypro*" OR "patient reported outcome*" OR "prom" OR "proms" OR "survey*" OR.

"questionnaire*") OR AB ("quality of life" OR "qol" OR "hrqol" OR "satisfaction" OR.

"thypro*" OR "patient reported outcome*" OR "prom" OR "proms" OR "survey*" OR.

"questionnaire*")).

PsycINFO (EBSCO).

March 16, 2021.

2 Records

(DE ("Goiters" AND "Thyroidectomy") OR TI (("goiter*" OR "goitre*") AND ("thyroidectom*".

OR "strumecto*" OR "lobectom*" OR "surgery" OR "surgical" OR "operative")) OR AB.

(("goiter*" OR "goitre*") AND ("thyroidectom*" OR "strumecto*" OR "lobectom*" OR.

"surgery" OR "surgical" OR "operative"))).

AND

(DE ("Quality of Life" OR "Health Related Quality of Life" OR "Patient Reported Outcome.

Measures" OR "Surveys" OR "Questionnaires") OR TI ("quality of life" OR "qol" OR "hrqol".

OR "satisfaction" OR "thypro*" OR "patient reported outcome*" OR "prom" OR "proms" OR.

"survey*" OR "questionnaire*") OR AB ("quality of life" OR "qol" OR "hrqol" OR.

"satisfaction" OR "thypro*" OR "patient reported outcome*" OR "prom" OR "proms" OR.

"survey*" OR "questionnaire*")).

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Chaves, N., Rodriguez, M.J., Broekhuis, J.M. et al. Quality of Life in Patients with Benign Non-Toxic Goiter After Surgical Intervention: A Systematic Review and Meta-Analysis. World J Surg 46, 1093–1104 (2022). https://doi.org/10.1007/s00268-022-06452-w

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