TRAIL Study: Feasibility and Pilot

Inclusion Criteria: * Participants must be ≥18 years of age. * Participants must be able and willing to provide informed consent or have a surrogate capable of providing same. * Participants must be absent of symptoms referable to the nodule: dysphagia or nodule physically visible and/or bothersome to patient. * Participants' thyroid nodule must have a TI-RADS rating of 4 or 5. * Participants thyroid nodule must be ≤2 cm in largest diameter. * Participants must be being considered for biopsy. * Participants with a prior history of papillary thyroid cancer are eligible. Exclusion Criteria: Patients who fall into one of the following categories will NOT be eligible for this study: * Adults who are unable to provide informed consent. * Patients for whom biopsy is not a consideration. * Patients with a prior history of thyroid cancer other than papillary thyroid cancer. * Patients with a history of radiation to the neck. * Patients who are athyroidal (thyroid gland has been removed or patient has only lingual thyroid tissue). * Patients who have ultrasound evidence of one or more of the following: * Airway invasion of the nodule. * Nodule adjacency to/invading the recurrent nerve. * Extra-thyroidal invasion by the nodule. * Patients who have metastasis to cervical lymph nodes (confirmed by needle biopsy if ultrasound suspicious), distant metastases, if identified) testing not required, not usual care) * Patients who have already had a biopsy of the nodule being considered for inclusion in the study. TRAIL Pilot Integrated QRI: Inclusion/Exclusion Criteria Inclusion Criteria for Study Patient Participants: * Participants must meet the eligibility requirements above and will be or have been approached about enrolling in the pilot study. * Participants must be willing to allow audio recorder presence and / or willing to be interviewed by the QRI team. Exclusion Criteria for Study Patient Participants: -Patients who are not willing to allow audio recorder presence and/or not willing to be interviewed by QRI team will be excluded from this study. Inclusion Criteria for Study Staff Participants: * Staff must be willing to audio record their communications with patients about enrolling in the study. * Staff must be willing to participate in interviews with QRI team about their views of the study. Exclusion Criteria for Study Staff Participants: -Staff members who are not willing to participate in audio taping of recruitment discussions and/or interviews with QRI team about their views of the study will be excluded.