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. 2020 Aug;64(4):356-361.
doi: 10.20945/2359-3997000000263. Epub 2020 Jun 29.

Cost effectiveness of intraoperative pathology in the management of indeterminate thyroid nodules

Christopher D Vuong  1 , WayAnne B Watson  2 , Daniel I Kwon  3 , Sonia S Mohan  4 , Mia N Perez  4 , Steve C Lee  1 , Alfred A Simental  1
Affiliations

Cost effectiveness of intraoperative pathology in the management of indeterminate thyroid nodules

Christopher D Vuong et al. Arch Endocrinol Metab. 2020 Aug.

Abstract

Objective This study aims to determine the cost effectiveness of rapid frozen section (RFS) for indeterminate thyroid nodules. Materials and methods A retrospective chart review was conducted between January 2009 and June 2013 at a tertiary care institution. Main outcomes were number needed to treat, RFS efficacy, and cost-savings of avoiding second completion thyroidectomy. Cost-effectiveness was estimated using 2015 Medicare reimbursement rate. Results Out of 1,114 patients undergoing thyroid surgery, 314 had preoperative AUS/FLUS cytopathology and subsequent thyroid lobectomy with RFS. RFS identified 13 of the 32 patients with malignancy resulting in a total thyroidectomy. 19 of the 29 malignancies not detected by RFS were papillary microcarcinomas. Conclusions Completion thyroidectomy was avoided in 1 out of every 24 patients resulting in cost-savings of $ 80.04 per patient. In the era of outpatient thyroid surgery, intraoperative RFS for indeterminate thyroid nodules is cost-effective.

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Conflict of interest statement

Disclosure: no potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1. Results of Bethesda class III surgery with intraoperative consultation at our institution.
See this image and copyright information in PMC

Comment in

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