Fine-needle aspiration biopsy versus ultrasoundguided fine-needle aspiration biopsy: Costeffectiveness as a frontline diagnostic modality for solitary thyroid nodules
Fine-needle aspiration biopsy versus ultrasoundguided fine-needle aspiration biopsy: Costeffectiveness as a frontline diagnostic modality for solitary thyroid nodules
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DOI：
10.1002/hed.20829
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发表时间：
2008-08-01
影响因子：
2.9
通讯作者：
Stack, Brendan C., Jr.
中科院分区：
文献类型：
--
作者：
Khalid, Ayesha N.;Quraishi, Sadeq A.;Stack, Brendan C., Jr.
背景资料。当细针活检(FNAB)因细胞学不明确或标本缺乏而不确定时，超声引导下细针活检(FNAB)被认为是首选的诊断方法。利用决策树进行成本-效果分析，对诊断策略进行建模。决策分析模型使用大型学术医学中心的成本和现有文献中的概率进行参数化。结果包括每增加一个正确诊断病例的增量成本。所有数据报告为一线超声引导的FNAB策略与FNAB策略--预期成本：1329美元与1312美元；预期正确诊断病例数(每1000次活检)：980例与920例；每个额外正确诊断病例的增量成本：289美元。使用超声引导的FNAB作为甲状腺结节组织活检的初始方式比传统的FNAB更有效，每增加一个正确的诊断需要额外的费用289美元。(C)2008年威利期刊公司。
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. (c) 2008 Wiley Periodicals, Inc.