ArticleBMJ open2024
Impact of perioperative diagnostic tools on clinical outcomes and cost-effectiveness in parathyroid surgery: a decision model-based analysis.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- The Economics of Intraoperative Parathyroid Hormone Monitoring for Parathyroid Surgery: A Scoping Review of Cost Analyses and Economic Evaluations.Laryngoscope investigative otolaryngology · 2026Review
- Interpreting the drop: concordance and disparity between a new point-of-care assay and laboratory intraoperative parathyroid hormone testing in parathyroid surgery.BMC endocrine disorders · 2026Article
- Preoperative Lugol's solution and surgical outcomes in Graves' disease: a single-center retrospective study.Frontiers in surgery · 2026Article
- Primary Hyperparathyroidism: 18F-Fluorocholine PET/CT vs. 4D-CT for Parathyroid Identification: Toward a Comprehensive Diagnostic Framework-An Updated Review and Recommendations.Journal of clinical medicine · 2025Review
- Preoperative phosphorus levels may serve as a predictor of recurrent/persistent lesions after surgery for primary hyperparathyroidism: a cross-sectional study.Gland surgery · 2025Article
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Authors and funding
4 authors.
Funding
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Abstract
objectivesPreoperative and intraoperative diagnostic tools influence the surgical management of primary hyperparathyroidism (PHPT), whereby their performance of classification varies considerably for the two common causes of PHPT: solitary adenomas and multiglandular disease. A consensus on the use of such diagnostic tools for optimal perioperative management of all PHPT patients has not been reached.
designA decision tree model was constructed to estimate and compare the clinical outcomes and the cost-effectiveness of preoperative imaging modalities and intraoperative parathyroid hormone (ioPTH) monitoring criteria in a 21-year time horizon with a 3% discount rate. The robustness of the model was assessed by conducting a one-way sensitivity analysis and probabilistic uncertainty analysis.
settingThe US healthcare system. POPULATION: A hypothetical population consisting of 5000 patients with sporadic, symptomatic or asymptomatic PHPT.
interventionsPreoperative and intraoperative diagnostic modalities for parathyroidectomy.
main outcome measuresCosts, quality-adjusted life-years (QALYs), net monetary benefits (NMBs) and clinical outcomes.
resultsIn the base-case analysis, four-dimensional (4D) CT was the least expensive strategy with US$10 276 and 15.333 QALYs. Ultrasound and
conclusions4D-CT is the most cost-effective modality for the preoperative localisation of solitary parathyroid adenomas and multiglandular disease. The use of ioPTH monitoring is not cost-effective, but to minimise clinical complications, the Miami criterion should be applied for suspected solitary adenomas and the Vienna criterion for multiglandular disease.
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