Evidence map›Paper›PMID 26312216›Full record

ArticleGland surgery2015

A cost analysis of thyroid core needle biopsy vs. diagnostic surgery.

Pierpaolo Trimboli, Naim Nasrollah, Stefano Amendola, Anna Crescenzi, Leo Guidobaldi, Carlo Chiesa, Riccardo Maglio, Giuseppe Nigri, Alfredo Pontecorvi, Francesco Romanelli and 2 more

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In one paragraph

Article in Gland surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Pierpaolo Trimboli1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Naim Nasrollah1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Stefano Amendola1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Anna Crescenzi1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Leo Guidobaldi1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Carlo Chiesa1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Riccardo Maglio1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Giuseppe Nigri1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Alfredo Pontecorvi1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Francesco Romanelli1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Laura Giacomelli1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Stefano Valabrega1 Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy ; 2 Section of Surgery, Ospedale Israelitico, Rome, Italy ; 3 Pathology Unit, Campus Bio-medico University Hospital, Rome, Italy ; 4 Section of Pathology, Ospedale Israelitico, Rome, Italy ; 5 Department of Surgical Sciences, Sapienza University, Rome, Italy ; 6 Department of Surgical and Medical Sciences, Sapienza University, Ospedale S. Andrea, Rome, Italy ; 7 Institute of Endocrinology, Catholic University of Rome, 00168 Rome, Italy ; 8 Department of Experimental Medicine, Sapienza University, Rome, Italy.
Ospedale Israelitico · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTwenty percent of thyroid fine needle aspiration (FNA) is indeterminate. Because 3 in 4 of these are actually benign, a method of clarifying the pathology could help patients to avoid diagnostic thyroidectomy. Recently, core needle biopsy (CNB) has been proven to be highly reliable for this purpose. However, there are no reports of any potential cost benefit provided by CNB. Here we analyzed the impact on management costs of CNB compared with traditional diagnostic surgery in indeterminate FNA.

methodsOver 24 months, 198 patients with thyroid indeterminate cytology underwent CNB at Ospedale Israelitico of Rome or diagnostic surgery at the Department of Surgery of Sapienza University of Rome. We tabulated costs of the medical instruments, operating theater, surgical team, patient recovery, and pathologic examination for each method.

resultsIn CNB group, 42.4% of patients had benign lesions and avoided surgery, 20.8% was cancer, and the remaining 36.8% uncertain. The malignancy rate in CNB group was 26.4%, and mean cost of CNB per nodule was 1,032€. In diagnostic surgery group, 24.7% had cancer and 75.3% had benign lesions, and mean expense for each thyroidectomy was 6,364€. In an ideal cohort of 100 patients with indeterminate FNA, the cost of CNB is 33.8% lower than that of diagnostic surgery.

conclusionsCNB can detect a large proportion of the benign thyroid nodules that are classified as indeterminate by FNA. These patients can avoid diagnostic thyroidectomy and hospitals can reduce their surgical costs by one-third.

Indexed as

core needle biopsy (CNB)cost-effectivenesscytologysurgeryThyroid

Identifiers

PMID26312216
PMCPMC4523622
OpenAlexW746000765

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.