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Quality of Life and Cost-Effectiveness of Radiofrequency Ablation versus Open Surgery for Benign Thyroid Nodules: a retrospective cohort study

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ABSTRACT

This study is to compare the health-related quality of life (HRQoL) and cost-effectiveness of radiofrequency ablation (RFA) and open thyroidectomy (OT) for benign thyroid nodules (BTNs) treatment. HRQoL and utility were assessed for 404 BTN patients immediately before treatments (RFA:OT = 137:267) and at 6-month visit. A cost-effectiveness analysis was performed from societal perspective in the China context. Resource use (hospitalization, sick leaves) was collected. We used the net monetary benefit approach and computed cost-effectiveness acceptability curves for RFA and OT. Sensitivity analyses of costs of RFA were performed. At 6-month visit, patients treated with RFA had significantly better HRQoL than patients treated with OT on general health (68.5 versus 66.7, P = 0.029), vitality (71.3 versus 67.5, P < 0.001) and mental health (80.9 versus 79.3, P = 0.038). RFA was more effective than OT in terms of quality-adjusted life-years (QALYs; 0.01QALY/patient) but more expensive (US$823/patient). The probability that RFA would be cost effective at a US$50,000/QALY threshold was 15.5% in China, and it would be increased to 88.4% when price of the RFA device was lowered by 30%. RFA exhibited a significant improvement of HRQoL relative to OT, but is unlikely to be cost effective at its current price in short time.

No MeSH data available.


Graph shows the SF-36 dimension scores of the propensity score matched patients treated with radiofrequency ablation (RFA) or open thyroidectomy (OT) at 6 months follow up, together with those for the general population sample13.*P < 0.05,***P < 0.001.
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f3: Graph shows the SF-36 dimension scores of the propensity score matched patients treated with radiofrequency ablation (RFA) or open thyroidectomy (OT) at 6 months follow up, together with those for the general population sample13.*P < 0.05,***P < 0.001.

Mentions: The SF-36 scale scores of the propensity score mathed patients with BTNs that treated with RFA or OT at 6 months follow up are shown in Fig. 3, together with those for the general population sample13. 6 months after treatments, in the RFA group the HRQoL scores were significantly improved on GH (68.5 versus 65.3, P = 0.012), RE (96.6 versus 91.7, P = 0.007) and MH (80.9 versus 75.3, P = 0.002), and in the OT group they were improved on RE (94.4 versus 91.0, P = 0.049) and MH (79.3 versus 76.0, P = 0.011). Further, patients treated with RFA had significantly better HRQoL than patients treated with OT on GH (68.5 versus 66.7, P = 0.029), VT (71.3 versus 67.5, P < 0.001) and MH (80.9 versus 79.3, P = 0.038) at 6 months follow up (Fig. 3). And, compared the general population sample, the OT patients still exhibited significantly lower scores on three scales (GH: 66.7 versus 68.8, P < 0.001; VT, 67.5 versus 71.8, P < 0.001 and MH, 79.3 versus 81.8, P < 0.001), while there were no differences between the RFA group patients and the general population on all the scale scores at 6 months follow-up.


Quality of Life and Cost-Effectiveness of Radiofrequency Ablation versus Open Surgery for Benign Thyroid Nodules: a retrospective cohort study
Graph shows the SF-36 dimension scores of the propensity score matched patients treated with radiofrequency ablation (RFA) or open thyroidectomy (OT) at 6 months follow up, together with those for the general population sample13.*P < 0.05,***P < 0.001.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121639&req=5

f3: Graph shows the SF-36 dimension scores of the propensity score matched patients treated with radiofrequency ablation (RFA) or open thyroidectomy (OT) at 6 months follow up, together with those for the general population sample13.*P < 0.05,***P < 0.001.
Mentions: The SF-36 scale scores of the propensity score mathed patients with BTNs that treated with RFA or OT at 6 months follow up are shown in Fig. 3, together with those for the general population sample13. 6 months after treatments, in the RFA group the HRQoL scores were significantly improved on GH (68.5 versus 65.3, P = 0.012), RE (96.6 versus 91.7, P = 0.007) and MH (80.9 versus 75.3, P = 0.002), and in the OT group they were improved on RE (94.4 versus 91.0, P = 0.049) and MH (79.3 versus 76.0, P = 0.011). Further, patients treated with RFA had significantly better HRQoL than patients treated with OT on GH (68.5 versus 66.7, P = 0.029), VT (71.3 versus 67.5, P < 0.001) and MH (80.9 versus 79.3, P = 0.038) at 6 months follow up (Fig. 3). And, compared the general population sample, the OT patients still exhibited significantly lower scores on three scales (GH: 66.7 versus 68.8, P < 0.001; VT, 67.5 versus 71.8, P < 0.001 and MH, 79.3 versus 81.8, P < 0.001), while there were no differences between the RFA group patients and the general population on all the scale scores at 6 months follow-up.

View Article: PubMed Central - PubMed

ABSTRACT

This study is to compare the health-related quality of life (HRQoL) and cost-effectiveness of radiofrequency ablation (RFA) and open thyroidectomy (OT) for benign thyroid nodules (BTNs) treatment. HRQoL and utility were assessed for 404 BTN patients immediately before treatments (RFA:OT&thinsp;=&thinsp;137:267) and at 6-month visit. A cost-effectiveness analysis was performed from societal perspective in the China context. Resource use (hospitalization, sick leaves) was collected. We used the net monetary benefit approach and computed cost-effectiveness acceptability curves for RFA and OT. Sensitivity analyses of costs of RFA were performed. At 6-month visit, patients treated with RFA had significantly better HRQoL than patients treated with OT on general health (68.5 versus 66.7, P&thinsp;=&thinsp;0.029), vitality (71.3 versus 67.5, P&thinsp;&lt;&thinsp;0.001) and mental health (80.9 versus 79.3, P&thinsp;=&thinsp;0.038). RFA was more effective than OT in terms of quality-adjusted life-years (QALYs; 0.01QALY/patient) but more expensive (US$823/patient). The probability that RFA would be cost effective at a US$50,000/QALY threshold was 15.5% in China, and it would be increased to 88.4% when price of the RFA device was lowered by 30%. RFA exhibited a significant improvement of HRQoL relative to OT, but is unlikely to be cost effective at its current price in short time.

No MeSH data available.