title: Quality of Life and Cost-Effectiveness of Radiofrequency Ablation versus Open Surgery for Benign Thyroid Nodules: a retrospective cohort study.
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.
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Shanghai Center for Thyroid Diseases, Shanghai, 200072, China.
authors.forename: Wen-Wen
authors.initials: WW
authors.lastname: Yue
authors.forename: Shu-Rong
authors.initials: SR
authors.lastname: Wang
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Shanghai Center for Thyroid Diseases, Shanghai, 200072, China.
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Li
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Shanghai Center for Thyroid Diseases, Shanghai, 200072, China.
authors.forename: Hui-Xiong
authors.initials: HX
authors.lastname: Xu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Shanghai Center for Thyroid Diseases, Shanghai, 200072, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Lu
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Shanghai Center for Thyroid Diseases, Shanghai, 200072, China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Sun
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Shanghai Center for Thyroid Diseases, Shanghai, 200072, China.
authors.forename: Le-Hang
authors.initials: LH
authors.lastname: Guo
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Shanghai Center for Thyroid Diseases, Shanghai, 200072, China.
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: He
authors.affiliation: Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Shanghai Center for Thyroid Diseases, Shanghai, 200072, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.affiliation: Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China.|Shanghai Center for Thyroid Diseases, Shanghai, 200072, China.|Center of Diagnosis and Treatment for Thyroid Diseases, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Yin
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000191:economics*; D002681:China; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D016606:Thyroid Nodule / Q000601:surgery*; D013965:Thyroidectomy / Q000191:economics / Q000379:methods*