Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 1 de 1
Filtrar
Mais filtros

Bases de dados
País/Região como assunto
Ano de publicação
Tipo de documento
País de afiliação
Intervalo de ano de publicação
1.
Surgery ; 152(3): 423-30, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22938902

RESUMO

BACKGROUND: The 2007 National Cancer Institute (NCI) conference on Thyroid Fine-Needle Aspiration (FNA) introduced the category atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS). Repeat FNA in 3 to 6 months was recommended for low-risk patients. Compliance with these recommendations has been suboptimal. We hypothesized that repeat FNA would be more effective than diagnostic lobectomy, with decreased costs and improved rates of cancer detection. METHODS: Cost-effectiveness analysis was performed in which we compared diagnostic lobectomy with repeat FNA. A Markov model was developed. Outcomes and probabilities were identified from literature review. Third-party payer costs were estimated in 2010 US dollars. Outcomes were weighted by use of the quality-of-life utility factors, yielding quality-adjusted life years (QALYs). Monte Carlo simulation and sensitivity analysis were used to examine the uncertainty of probability, cost, and utility estimates. RESULTS: The diagnostic lobectomy strategy cost $8,057 and produced 23.99 QALYs. Repeat FNA cost $2,462 and produced 24.05 QALYs. Repeat FNA was dominant until the cost of FNA increased to $6,091. Dominance of the repeat FNA strategy was not sensitive to the cost of operation or the complication rate. CONCLUSION: The NCI recommendations for repeat FNA regarding follow-up of AUS/FLUS results are cost-effective. Improving compliance with these guidelines should lead to less overall costs, greater quality of life, and fewer unnecessary operations.


Assuntos
Biópsia por Agulha Fina/economia , Doenças da Glândula Tireoide/economia , Doenças da Glândula Tireoide/patologia , Análise Custo-Benefício , Custos e Análise de Custo , Custos Hospitalares , Humanos , Cadeias de Markov , Modelos Estatísticos , Anos de Vida Ajustados por Qualidade de Vida , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/terapia , Tireoidectomia/economia , Estados Unidos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA