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- Publisher Website: 10.1007/s40618-020-01254-0
- Scopus: eid_2-s2.0-85084074748
- PMID: 32307641
- WOS: WOS:000528497100001
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Article: Cost-effectiveness of fine-needle aspiration cytology (FNAC) and watchful observation for incidental thyroid nodules
Title | Cost-effectiveness of fine-needle aspiration cytology (FNAC) and watchful observation for incidental thyroid nodules |
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Authors | |
Keywords | Fine-needle aspiration Thyroid nodule Randomized controlled trial QALYs Cost-effectiveness analysis |
Issue Date | 2020 |
Publisher | Springer. The Journal's web site is located at https://link.springer.com/journal/40618 |
Citation | Journal of Endocrinological Investigation, 2020, v. 43, p. 1645-1654 How to Cite? |
Abstract | Objectives: A trial-based comparison of the use of resources, costs and health utility outcomes of fine-needle aspiration cytology (FNAC), and watchful observation for incidental small (< 2 cm) thyroid nodules was performed using data from the randomized controlled trial (RCT). Methods: Using data from 314 patients, healthcare-related use of resources, costs, health utility, and quality-adjusted life years (QALYs) were estimated at 12 months after first presentation of incidental thyroid nodule(s) on an intention-to-treat basis with adjustment for covariates. Uncertainty about the incremental cost-effectiveness ratio for FNAC versus watchful management at 12 months of follow-up was incorporated using bootstrapping. Multiple imputation methods were used to deal with missing data. Results: FNAC management was associated with greater use of healthcare resources and mean direct healthcare costs per patient (US$542.47 vs US$411.55). Lower mean 12-month QALYs per patient in FNAC was observed in comparison to watchful observation (0.752 versus 0.758). The probability that FNAC management was cost-effective compared with watchful management at a willingness-to-pay threshold of US50,000 per QALY gained was 26.5%. Conclusion: Based on 12-month data from RCT, watchful observation appeared cost-saving compared to FNAC in patients with incidental thyroid nodules that have a low-suspicion sonographic pattern and measure between 1.0 and 2.0 cm from healthcare provider perspective. |
Persistent Identifier | http://hdl.handle.net/10722/282270 |
ISSN | 2023 Impact Factor: 3.9 2023 SCImago Journal Rankings: 1.067 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wong, CKH | - |
dc.contributor.author | LIU, X | - |
dc.contributor.author | Lang, BHH | - |
dc.date.accessioned | 2020-05-05T14:32:57Z | - |
dc.date.available | 2020-05-05T14:32:57Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Journal of Endocrinological Investigation, 2020, v. 43, p. 1645-1654 | - |
dc.identifier.issn | 0391-4097 | - |
dc.identifier.uri | http://hdl.handle.net/10722/282270 | - |
dc.description.abstract | Objectives: A trial-based comparison of the use of resources, costs and health utility outcomes of fine-needle aspiration cytology (FNAC), and watchful observation for incidental small (< 2 cm) thyroid nodules was performed using data from the randomized controlled trial (RCT). Methods: Using data from 314 patients, healthcare-related use of resources, costs, health utility, and quality-adjusted life years (QALYs) were estimated at 12 months after first presentation of incidental thyroid nodule(s) on an intention-to-treat basis with adjustment for covariates. Uncertainty about the incremental cost-effectiveness ratio for FNAC versus watchful management at 12 months of follow-up was incorporated using bootstrapping. Multiple imputation methods were used to deal with missing data. Results: FNAC management was associated with greater use of healthcare resources and mean direct healthcare costs per patient (US$542.47 vs US$411.55). Lower mean 12-month QALYs per patient in FNAC was observed in comparison to watchful observation (0.752 versus 0.758). The probability that FNAC management was cost-effective compared with watchful management at a willingness-to-pay threshold of US50,000 per QALY gained was 26.5%. Conclusion: Based on 12-month data from RCT, watchful observation appeared cost-saving compared to FNAC in patients with incidental thyroid nodules that have a low-suspicion sonographic pattern and measure between 1.0 and 2.0 cm from healthcare provider perspective. | - |
dc.language | eng | - |
dc.publisher | Springer. The Journal's web site is located at https://link.springer.com/journal/40618 | - |
dc.relation.ispartof | Journal of Endocrinological Investigation | - |
dc.rights | This is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: https://doi.org/[insert DOI] | - |
dc.subject | Fine-needle aspiration | - |
dc.subject | Thyroid nodule | - |
dc.subject | Randomized controlled trial | - |
dc.subject | QALYs | - |
dc.subject | Cost-effectiveness analysis | - |
dc.title | Cost-effectiveness of fine-needle aspiration cytology (FNAC) and watchful observation for incidental thyroid nodules | - |
dc.type | Article | - |
dc.identifier.email | Wong, CKH: carlosho@hku.hk | - |
dc.identifier.email | Lang, BHH: Blang@hku.hk | - |
dc.identifier.authority | Wong, CKH=rp01931 | - |
dc.identifier.authority | Lang, BHH=rp01828 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1007/s40618-020-01254-0 | - |
dc.identifier.pmid | 32307641 | - |
dc.identifier.scopus | eid_2-s2.0-85084074748 | - |
dc.identifier.hkuros | 309787 | - |
dc.identifier.volume | 43 | - |
dc.identifier.spage | 1645 | - |
dc.identifier.epage | 1654 | - |
dc.identifier.isi | WOS:000528497100001 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0391-4097 | - |