title: Neck lump clinics: is on-site assessment of fine needle aspirate diagnostic adequacy cost-effective?
abstract: OBJECTIVE
  To establish the diagnostic adequacy of ultrasound-guided fine needle aspiration cytology samples at the East Berkshire neck lump clinic, and to perform a cost-benefit analysis related to the hypothetical addition of an on-site cytology technician (required to review fine needle aspiration specimen adequacy).
  
  
  METHODS
  The adequacy of all ultrasound-guided fine needle aspiration procedures was reviewed from 1 January to 30 June 2011. These results were used in the cost-benefit analysis related to on-site cytology assessment.
  
  
  RESULTS
  Of the 307 ultrasound-guided fine needle aspiration cytology procedures performed over 6 months, 67 (22 per cent) were reported to be non-diagnostic. Operator experience was found to correlate significantly with diagnostic adequacy (p < 0.001). Only 5 per cent of all fine needle aspirations were initially non-diagnostic but diagnostic on repeat sampling. This suggests that the financial and time costs of on-site fine needle aspirate adequacy assessment would outweigh any benefit.
  
  
  CONCLUSIONS
  In this series, the experience of individuals performing fine needle aspirations was the most important factor related to adequacy.
authors.affiliation: ENT Department, Wexham Park Hospital, UK.
authors.forename: C
authors.initials: C
authors.lastname: Burgess
authors.forename: L
authors.initials: L
authors.lastname: Dias
authors.forename: E
authors.initials: E
authors.lastname: Maughan
authors.forename: R
authors.initials: R
authors.lastname: Moorthy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics / Q000592:standards; D044963:Biopsy, Fine-Needle / Q000191:economics / Q000592:standards; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D006258:Head and Neck Neoplasms / Q000191:economics / Q000473:pathology*; D006801:Humans; D061705:Image-Guided Biopsy / Q000191:economics / Q000592:standards; D007223:Infant; D008875:Middle Aged; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000191:economics / Q000592:standards; D055815:Young Adult