According to the new model study, ultrasonic observation is more efficient and less costly than the immediate biopsy of patients with suspicious thyroid intermediate nodes.
"These results confirm the new recommendations of clinical practice that many small thyroid nodules can be safely monitored with repeated ultrasound, but not immediately subjected to biopsy," - he said in an interview with Reuters, Dr. Kyle A. Zanokko of California School of Medicine, David Geffen in Los -Andzhelesa Health.
American Association recommends thyroid biopsy intermediate suspicious nodule size of 1.0 cm or more, since their risk of malignancy ranges from 10% to 20%.
Command Dr Zanokko used Markov Model transition state for comparing the economic efficiency of an immediate fine needle firing (FNA) against the ultrasonic observation for a 1.0-centimeter nodules thyroid sonographic features with intermediate suspicion.
ultrasonic monitoring strategy had a lower expected value (3 to $ 008.) and a slightly higher efficiency (23.792 considering the quality of life (QALY)), compared with a strategy of immediate biopsy (the United States and US $ 23.776 to $ 4837.. the United States).
Immediate biopsy has become a cost-effective compared with the ultrasonic observation only in the event that increased from 129 to 793 dollars the cost of ultrasound US quality adjustment factor for observation without immediate biopsy decreased from 1 to 0,998.
Ultrasound observation was cost-effective in every 10,000 practices and it was both less costly and more effective than immediate biopsy in 9995 simulations.
"Small, incidental thyroid nodules are often found after patients undergo cervical snapshot" - Dr. Zanokko said.
"Be reasonable with a biopsy of the thyroid gland, in turn, will reduce the unnecessary operation of the thyroid gland", - he said.
"This model is very sensitive to differences in utility between patients undergoing sonographic observation, and patients with benign biopsy results," - the researchers note. "It is therefore necessary additional primary research health-related quality of life in these groups."
"I do not think this study should influence the management of nodular thyroid. Decision-making for patients with thyroid nodes should be based on a detailed conversation about the risk of malignancy, on how patients appreciate the risk attributes of different management strategies and the context of the patient. "
Dr. Brito Campana added: "In order to support decision-making with patients, it would be useful to understand what the actual costs patients have to pay when they choose different control options."