title: The harmonic study: cost-effectiveness evaluation of the use of the ultrasonic scalpel in total thyroidectomy.
abstract: BACKGROUND
  Total thyroidectomy (TT) can be performed either with the traditional technique or using the ultrasound scalpel. Here, the use of the ultrasound scalpel is investigated in order to assess cost-effectiveness from an hospital, third party payer and societal perspective.
  
  
  METHODS
  A randomized controlled trial was conducted at the University Hospital A. Gemelli in Rome. Data refer to 198 patients, randomized to either surgery with the ultrasound scalpel (n = 96) or traditional (n = 102) and followed for 3 months after hospital discharge. Operation time (OT) and resource consumption were recorded. Main clinical outcome investigated was quality of life (evaluated with EQ-5D).
  
  
  RESULTS
  A shorter operation time (traditional: 76.36 vs ultrasound: 54.16 minutes, p < 0.001) was observed. 3 months after surgery, differences in QoL were significant (0.91 vs 0.84, p = 0.002). Concerning the hospital perspective, ultrasound scalpel allows savings of 119 EUR per patient. From a societal perspective, ultrasound scalpel is also related to lower medical resource consumption during a 3 month follow-up after discharge (traditional: 129.03 EUR vs ultrasound: 107.82 EUR) and lower non-medical resource utilization (transport/hotels costs traditional:535.51 EUR vs ultrasound: 342.77 EUR. No statistical difference was found in productivity losses up to 3 months (traditional: 377.71 EUR vs ultrasound: 385.51 EUR).
  
  
  CONCLUSIONS
  Allowing an overall saving of 325.36 EUR per patient, Ultrasound scalpel should be adopted for TT procedures in the "A.Gemelli" University hospital.
authors.affiliation: Università Cattolica del Sacro Cuore, Rome, Italy. mruggeri@rm.unicatt.it
authors.forename: Matteo
authors.initials: M
authors.lastname: Ruggeri
authors.forename: Rossella
authors.initials: R
authors.lastname: Dibidino
authors.forename: Marco
authors.initials: M
authors.lastname: Marchetti
authors.forename: Celestino Pio
authors.initials: CP
authors.lastname: Lombardi
authors.forename: Marco
authors.initials: M
authors.lastname: Raffaelli
authors.forename: Americo
authors.initials: A
authors.lastname: Cicchetti
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012384:Rome; D013525:Surgical Instruments; D013965:Thyroidectomy / Q000191:economics* / Q000379:methods*; D014464:Ultrasonic Therapy / Q000295:instrumentation*; D055815:Young Adult