Fine-needle aspiration biopsy versus ultrasound-guided fine-needle aspiration biopsy: Cost-effectiveness as a frontline diagnostic modality for solitary thyroid nodules

✍ Scribed by Ayesha N. Khalid; Sadeq A. Quraishi; Christopher S. Hollenbeak; Brendan C. Stack Jr.

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 92 KB
• Volume: 30
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.20829

✦ Synopsis

Abstract

Background

Ultrasound‐guided fine‐needle aspiration biopsy (ultrasound‐guided FNAB) is considered the diagnostic test of choice when a fine‐needle aspiration biopsy (FNAB) returns an inconclusive diagnosis because of cytologic ambiguity or paucity of specimen.

Methods

Cost‐effectiveness analysis utilizing a decision tree was used to model the diagnostic strategies. The decision analysis model was parameterized using costs from a large, academic medical center and probabilities from existing literature. Outcomes included the incremental cost per additional case correctly diagnosed.

Results

All data are reported as frontline ultrasound‐guided FNAB strategy versus FNAB strategy—expected cost: $1329 versus $1312; expected number of cases correctly diagnosed (per 1000 biopsies): 980 versus 920; incremental cost per additional correctly diagnosed case: $289.

Conclusion

The use of ultrasound‐guided FNAB as the initial modality for tissue biopsy of a thyroid nodule is more effective than traditional FNAB at an additional cost of $289 per additional correct diagnosis. © 2008 Wiley Periodicals, Inc. Head Neck, 2008