Ablative Technologies for Thyroid Nodules: A Health Technology Assessment.

Area of Science:

• Endocrinology
• Minimally Invasive Surgery
• Health Technology Assessment

Background:

• Thyroid nodules are common, with most benign cases not requiring intervention.
• Surgery is considered for symptomatic, hyperthyroid, or potentially malignant nodules.
• Ablative technologies present a minimally invasive alternative to surgery.

Purpose of the Study:

• To conduct a health technology assessment of ablative technologies for thyroid nodules.
• To evaluate effectiveness, safety, cost-effectiveness, and patient preferences.
• To assess the budget impact of publicly funding ablative technologies.

Main Methods:

• Systematic literature search of clinical evidence and economic analyses.
• Inclusion of systematic reviews and primary studies, with risk of bias assessment.
• Cost-utility analyses from a public payer perspective and budget impact analysis.

Main Results:

• Thermal ablations may be as effective as surgery for symptomatic benign nodules and small papillary thyroid cancer, with better quality of life.
• Radiofrequency ablation (RFA) is more effective and less costly than surgery for symptomatic benign nodules and autonomously functioning thyroid nodules (AFTNs).
• RFA is cost-effective for small papillary thyroid cancer and public funding could lead to significant cost savings.

Conclusions:

• Ablative technologies, particularly RFA, show promise as effective and safer alternatives to surgery for thyroid nodules.
• RFA offers improved cost-effectiveness and potential for substantial healthcare savings.
• Patient preference for minimally invasive options like RFA highlights its value in improving quality of life.