Table 5.

Cost-effectiveness comparison between palpation- and ultrasound-guided thyroid fine-needle aspiration biopsies with costs from this study and outcomes from previous studies

Author Year	n	P-FNA Inadequate	P-FNA Strategy Cost*	P-FNA Accuracy	USG-FNA Inadequate	USG-FNA Strategy Cost*	USG-FNA Accuracy	ICER	Reference
Danese 1998	9683	9%	€270	0.73	4%	€337	0.76	+€2233	[3]
Hatada 1998	166	30%	€395	0.48	17%	€413	0.68	+€90	[4]
Cesur 2006	285	32%	€430	0.77	21%	€437	0.89	+€58	[5]
Izquierdo 2006	376	11%	€290	0.61	7%	€344	0.80	+€284	[6]
Can 2009	268	42%	€534	0.64	29%	€523	0.72	-€138	This study

n: total number of nodules, P-FNA: palpation-guided thyroid fine-needle aspiration biopsy, Inadequate: inadequate rate, USG-FNA: ultrasound-guided thyroid fine-needle aspiration biopsy, ICER: incremental cost-effectiveness ratio. ICER is calculated by dividing the difference between strategy cost of USG-FNA and strategy cost of P-FNA to the difference between accuracy of USG-FNA and P-FNA. A positive ICER value indicates more, a negative ICER value indicates less expense for USG-FNA strategy over P-FNA strategy *Strategy cost is derived from figure 1 or 2, table 1 and cytology outcomes from references.