Open to Accrual

Decision Making & Patient Values in Thyroid Care

The overall goal of this project is to construct an ethnographic decision model on patient decision-making when facing a new thyroid cancer diagnosis, and pilot a decision navigation tool to improve patients’ decision outcomes. 

Wu

Open to Accrual

Chinese-American Patients’ Perceptions and Barriers to Thyroid Disease Care

Previous research suggests that cancer care varies by language spoken and poor communication between patient and provider results in lower patient satisfaction and education about health. Furthermore, research has illustrated existing racial disparities due to mistrust in the healthcare system, lack of multicultural competency of providers, and lack of health literacy among some patients. By interviewing Chinese-Americans in their native language, this study aims to identify the misconceptions and roots of distrust among Chinese-American patients about thyroid care.

Wu

Open to Accrual

R21 MAPS Trial

Ideal surgical extent for differentiated thyroid cancer remains unclear. Routine use of molecular analysis in biopsy-proven thyroid cancer could provide important prognostic information to help guide extent of surgery – thyroid lobectomy versus total thyroidectomy. This is a pilot feasibility study for the use of routine molecular analysis in Bethesda V and VI thyroid cancers, with randomization of the intermediate-molecular risk subgroup to thyroid lobectomy and total thyroidectomy. We hypothesize that patients will 1) agree to preoperative molecular analysis, and 2) 50% of intermediate-risk patients will agree to and follow through with randomization. This will be a pilot study for a future randomized controlled trial (RTC) to compare between the two surgical approaches in intermediate-molecular risk thyroid cancer. 

Livhits

Open to Accrual

NIH SBIR Assessment of Indeterminate Thyroid Nodules Utilizing Proteomics Assay

Our goals are to further our mechanistic understanding of protease biology in the context of thyroid tumorigenesis, and to identify lead candidate differentiating protease activities with valuable potential as diagnostic, imaging, or therapeutic biomarkers; the future goal will be to further optimize and rigorously test these markers against the currently approved clinical and diagnostic standards, with the aim of guiding clinical decision-making to avoid unnecessary surgical interventions. If successful, this proposal will lay the groundwork for the development of an actionable diagnostic test that will enable improved risk stratification of indeterminate thyroid nodules, and transform the clinical management of these challenging lesions.

Yeh, Livhits

Open to Accrual

POINT B 

Patients who undergo breast surgery will be randomized to an opt-in program for narcotics (POINT program), where they will be empowered to choose if they want narcotic pain medication upon discharge, versus usual care. We hypothesize an opt-in program will reduce opioid consumption without increasing pain score or decreasing patient’s quality of life. We aim to compare the impact of POINT program versus routine prescription of narcotic pain medication on postoperative pain scores and opioid consumption in outpatient breast surgery 

Yeh, Wu

Open to Accrual

Isolation and Characterization of Extracellular Vesicles in Patients with Thyroid Nodules and Thyroid Cancer

Extracellular vesicles are lipid membrane encapsulated particles shed into the extracellular space by cells. The molecular profile of thyroid tumor derived EVs is not well characterized. This is a feasibility study focused on the adaptation of a nanovilli chip to capture thyroid derived extracellular vesicles (EVs). The nanovilli chip was developed at UCLA by co-investigator Dr. Hsian-Rong Tseng and has been used to capture circulating tumor cells and extracellular vesicles from the blood of patients with hepatocellular carcinoma and lung cancer. Molecular profiling of thyroid EVs in patients with suspicious thyroid nodules could help discriminate benign thyroid adenomas from thyroid cancer, detect high risk mutations to guide therapy, and act as a biomarker for persistent or recurrent thyroid cancer following therapy.

Wu