PhD defence C.M.J. (Caroline) van Kinschot

Brief summary on the aim of the doctoral thesis:

The research presented in this thesis aimed to provide insights that will contribute to a patient tailored approach in several thyroid and parathyroid diseases. Special attention was paid to differences between patients when it comes to disease characteristics and patient' preferences. One of the outcomes of the research was that the number of lymphnode metastases in papillary thyroid cancer, but not the size of the metastases, predicted treatment response. This finding has the potential to improve preoperative risk stratification. Furthermore, treatment preferences in Graves disease were studied. It turned out that patients had a negative preference towards treatment with radioactive iodine, whereas clinicians preferred radioactive iodine over surgery. Increased appreciation of patients' concerns related to radioactive iodine treatment may improve adequate counselling and alleviate anxiety. Also a symptom-based algorithm for the management of low levels of calcium in the blood after thyroid surgery was studied. It was found that this algorithm safely reduced the proportion of patients receiving supplementation after surgery. Consequently, this reduced also the number of blood tests and the number of visits to the outpatient clinic.