title: Patients' perceptions and views of surgery and radioiodine ablation in the definitive management of Graves' disease.
abstract: BACKGROUND
  Patients' perceptions and preferences influence the choice of radioiodine ablation (RIA) or surgery in the definitive management of Graves' disease. This study aimed to evaluate their concerns, experiences and satisfaction following definitive treatment.
  
  
  METHODS
  A postal survey of patients who had treatment with surgery or RIA between January 2011 and June 2013 for Graves' disease was conducted.
  
  
  RESULTS
  Of 214 patients, 136 (64%) responded. The majority of patients felt actively involved in decision making (83.8%) and were satisfied (84.9%) with their treatment. Compared with RIA, patients who underwent surgery were more satisfied with their treatment (p=0.008). Discussion with the doctor was the most useful aid to decision making. Feeling involved in decision-making process was associated with improved satisfaction (p<0.001).Common reasons for not choosing surgery were need for general anaesthesia, scarring and voice change. Avoiding close contact, risk of persistent hyperthyroidism and worsening eye disease were common reasons for not choosing RIA. Ongoing concerns were hypothyroidism, scarring and eye problems after surgery and hypothyroidism and eye problems after RIA.
  
  
  CONCLUSIONS
  This study provides insight into patients' experiences of surgery and RIA for Graves' disease and reinforces the importance of patient involvement in the decision-making process.
authors.affiliation: Department of Oncology, University of Sheffield, Sheffield, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: Hookham
authors.affiliation: Endocrine Surgical Unit, Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Peter
authors.identifier: http://orcid.org/0000-0002-1309-0813
authors.initials: P
authors.lastname: Truran
authors.affiliation: Department of Endocrinology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Amit
authors.initials: A
authors.lastname: Allahabadia
authors.affiliation: Department of Oncology, University of Sheffield, Sheffield, UK.|Endocrine Surgical Unit, Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Sabapathy P
authors.initials: SP
authors.lastname: Balasubramanian
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006111:Graves Disease / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D011795:Surveys and Questionnaires; D013965:Thyroidectomy
chemical_list: D007457:Iodine Radioisotopes
keywords: Graves; Hyperthyroidism; Radioiodine; Thyroidectomy