Figure 5: Suggestion for managemental algorithm integrating the patient’s preference and the genetic status. In the case of lrPTMC (as defined in the ATA guidelines) a shared decision making is required, including a discussion between the patient and the physician, in order to inform the patient regarding the possible strategies and explore his/her preferred approach, which represents the utility he would assign to each strategy. That may include evaluating factors according to his/her perception, general medical state, and familial/social support. If there is no clear preference for one of the strategies,BRAF V600E testing would be recommended.