ArticleJournal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale2022
Cost-effectiveness analysis of molecular testing for cytologically indeterminate thyroid nodules.
Article in Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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.
The trial behind it
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.
Who cites it
19 citing papers in PubMed.
- Cost-effectiveness of talazoparib for patients with germline BRCA1/2 mutated HER2-negative advanced breast cancer in China and the US.Scientific reports · 2024Trial
- National Trends in Thyroidectomy and Molecular Diagnostic Utilization: A Medicare Analysis (2016-2023).The Laryngoscope · 2026Article
- Observational
- Micro-costing of genetic and genomic testing in oncology: a systematic review of laboratory resources and costs.Health economics review · 2026Review
- Machine learning-based classification of papillary thyroid carcinoma versus multinodular goiter using preoperative laboratory and cytology data.BMC endocrine disorders · 2026Article
- Impact of reflexive preoperative molecular testing for indeterminate nodules on lobectomy and completion thyroidectomy rates.European thyroid journal · 2026Article
- The actual and future role of molecular tests in thyroid pathology.Virchows Archiv : an international journal of pathology · 2026Review
- Diagnostic accuracy of thyroid nodules with indeterminate cytology when combined with ultrasonographic risk.Saudi medical journal · 2025Article
- Molecular Diagnostics and Personalized Therapeutics in Differentiated Thyroid Carcinoma: A Clinically Oriented Review.Diagnostics (Basel, Switzerland) · 2025Review
- The management of cytologically indeterminate thyroid nodules in clinical practice: A contemporary perspective with focus on molecular imaging.Endocrine · 2025Review
- Thyroid nodules: diagnosis and management.Nature reviews. Endocrinology · 2024Review
- The Unappreciated Value of a Cheap, 'Good Enough' Method of Detecting Thyroid Cancer.Journal of clinical medicine · 2024Review
- Thermal ablation for Bethesda III and IV thyroid nodules: current diagnosis and management.Ultrasonography (Seoul, Korea) · 2024Article
- Assessment of the risk of malignancy in Bethesda III thyroid nodules: a comprehensive review.Endocrine · 2024Review
- BRAF Detection in FNAC Combined with Semi-QuantitativeDiagnostics (Basel, Switzerland) · 2024Article
- Current State of Molecular Cytology in Thyroid Nodules: Platforms and Their Diagnostic and Theranostic Utility.Journal of clinical medicine · 2024Review
- Evolving approaches in paediatric thyroid cytopathology: A review.Cytopathology : official journal of the British Society for Clinical Cytology · 2024Review
- Unnecessary thyroid surgery rate for suspicious nodule in the absence of molecular testing.European thyroid journal · 2023Article
- Cost-Effectiveness Analysis of Molecular Testing for Indeterminate Thyroid Nodules in Nova Scotia.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-facialeArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThyroid nodules affect up to 65% of the population. Although fine needle aspirate (FNA) cytology is the gold standard for diagnosis, 15-30% of results are indeterminate. Molecular testing may aid in the diagnosis of nodules and potentially reduce unnecessary surgery. However, these tests are associated with significant costs. The objective of this study was to evaluate the cost-effectiveness of Afirma, a commercially available molecular test, in cytologically indeterminate thyroid nodules.
methodsThe base case was a solitary thyroid nodule with no additional high-risk features and an indeterminate FNA. Decision tree analysis was performed from the single payer perspective with a 1-year time horizon. Costing data were collected through micro-costing methodology. A probabilistic sensitivity analysis was performed. The primary outcome was the incremental cost effectiveness ratio (ICER) of cost per thyroid surgery avoided.
resultsOver 1 year, mean cost estimates were $8176.28 with 0.58 effectiveness for the molecular testing strategy and $6016.83 with 0.07 effectiveness for current standard management. The ICER was $4234.22 per surgery avoided. At a willingness-to-pay (WTP) threshold of $5000 per surgery avoided, molecular testing is cost-effective with 63% certainty.
conclusionThis cost-effectiveness analysis suggests utilizing Afirma for indeterminate solitary thyroid nodules is a cost-effective strategy for avoiding unnecessary thyroid surgery. With a $5000 WTP threshold, molecular testing has a 63% chance of being the more cost-effective strategy. The cost effectiveness varies based on the cost of the molecular test and the value of Afirma for patients with indeterminate thyroid nodules depends on the WTP threshold to avoid unnecessary thyroid surgery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.