Quality of Life and Cost-Effectiveness of Radiofrequency Ablation versus Open Surgery for Benign Thyroid Nodules: a retrospective cohort study.
Quality of Life and Cost-Effectiveness of Radiofrequency Ablation versus Open Surgery for Benign Thyroid Nodules: a retrospective cohort study.
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DOI：
10.1038/srep37838
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发表时间：
2016-11-24
影响因子：
4.6
通讯作者：
Yin ZQ
中科院分区：
文献类型：
--
作者：
Yue WW;Wang SR;Li XL;Xu HX;Lu F;Sun LP;Guo LH;He YP;Wang D;Yin ZQ
本研究旨在比较射频消融（RFA）和开放性甲状腺切除术（OT）治疗良性甲状腺结节（BTNs）的健康相关生活质量（HRQoL）和成本-效果。在治疗前即刻（RFA：OT = 137：267）和6个月访视时评估了404例BTN患者的HRQoL和效用。在中国背景下，从社会角度进行了成本效益分析。收集资源使用情况（住院、病假）。我们使用了净货币效益方法，并计算了RFA和OT的成本效益可接受性曲线。对RFA的成本进行了敏感性分析。在6个月访视时，接受RFA治疗的患者在一般健康（68.5 vs 66.7，P = 0.029）、活力（71.3 vs 67.5，P < 0.001）和心理健康（80.9 vs 79.3，P = 0.038）方面的HRQoL显著优于接受OT治疗的患者。在质量调整生命年（QALY; 0.01QALY/患者）方面，RFA比OT更有效，但更昂贵（823美元/患者）。在中国，RFA在50，000美元/QALY阈值下具有成本效益的概率为15.5%，当RFA器械价格降低30%时，该概率将增加至88.4%。相对于OT，RFA表现出HRQoL的显著改善，但在短时间内以其当前价格不太可能具有成本效益。
This study is to compare the health-related quality of life (HRQoL) and cost-effectiveness of radiofrequency ablation (RFA) and open thyroidectomy (OT) for benign thyroid nodules (BTNs) treatment. HRQoL and utility were assessed for 404 BTN patients immediately before treatments (RFA:OT = 137:267) and at 6-month visit. A cost-effectiveness analysis was performed from societal perspective in the China context. Resource use (hospitalization, sick leaves) was collected. We used the net monetary benefit approach and computed cost-effectiveness acceptability curves for RFA and OT. Sensitivity analyses of costs of RFA were performed. At 6-month visit, patients treated with RFA had significantly better HRQoL than patients treated with OT on general health (68.5 versus 66.7, P = 0.029), vitality (71.3 versus 67.5, P < 0.001) and mental health (80.9 versus 79.3, P = 0.038). RFA was more effective than OT in terms of quality-adjusted life-years (QALYs; 0.01QALY/patient) but more expensive (US$823/patient). The probability that RFA would be cost effective at a US$50,000/QALY threshold was 15.5% in China, and it would be increased to 88.4% when price of the RFA device was lowered by 30%. RFA exhibited a significant improvement of HRQoL relative to OT, but is unlikely to be cost effective at its current price in short time.
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