Abstract
<jats:p>The aim of this thesis was to investigate whether shared decision making (SDM) between physicians and patients could be improved through the use of patient decision aids (PtDAs) in differentiated thyroid cancer (DTC). A systematic review demonstrated that, in low-risk DTC, a less extensive surgical approach (thyroid lobectomy) may result in comparable long-term outcomes to total thyroidectomy, highlighting the importance of SDM. Subsequently, the needs, preferences, and values of patients were explored regarding two key treatment decisions: the extent of surgery in low-risk DTC and the initiation versus postponement of tyrosine kinase inhibitors (TKIs) in advanced disease. Patients particularly emphasized the importance of a strong physician–patient relationship and comprehensive information provision. Based on these findings, web-based PtDAs were developed according to international quality standards. During testing phases, the PtDAs were considered clear, user-friendly, and supportive of decision making. A multicenter randomized controlled trial was conducted to assess their impact on SDM. Although all patients recommended the use of the PtDAs, no additional effect was observed on objectively measured SDM, patient knowledge, trust, or decision-related outcomes. This may be explained by already high SDM scores following physician training, resulting in a ceiling effect. Finally, this thesis underscores the importance of SDM in DTC care and provides recommendations for its further implementation and future research, particularly in the management of low-risk papillary thyroid carcinoma.</jats:p>