The cost-effectiveness of iodine 131 scintigraphy, ultrasonography, and fine-needle aspiration biopsy in the initial diagnosis of solitary thyroid nodules.

Publication/Presentation Date

3-1-2006

Abstract

OBJECTIVE: To compare the cost-effectiveness of fine-needle aspiration biopsy, iodine 131 scintigraphy, and ultrasonography for the initial diagnostic workup of a solitary palpable thyroid nodule.

DESIGN: A deterministic cost-effectiveness analysis was conducted using a decision tree to model the diagnostic strategies.

SETTING: A single, mid-Atlantic academic medical center.

MAIN OUTCOME MEASURES: Expected costs, expected number of cases correctly diagnosed, and incremental cost per additional case correctly diagnosed.

RESULTS: Relative to the routine use of fine-needle aspiration biopsy, the incremental cost per case correctly diagnosed is 24,554 dollars for the iodine 131 scintigraphy strategy and 1212 dollars for the ultrasound strategy.

CONCLUSIONS: A diagnostic strategy using initial fine-needle aspiration biopsy for palpable thyroid nodules was found to be cost-effective compared with the other approaches as long as a payor's willingness to pay for an additional correct diagnosis is less than 1212 dollars. Prospective studies are needed to validate these finding in clinical practice.

Volume

132

Issue

3

First Page

244

Last Page

250

ISSN

0886-4470

Disciplines

Community Health and Preventive Medicine | Health Services Research | Medicine and Health Sciences

PubMedID

16549743

Department(s)

Department of Community Health and Health Studies

Document Type

Article

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