pp 1–9 | Cite as

A randomized trial comparing health-related quality-of-life and utility measures between routine fine-needle aspiration cytology (FNAC) and surveillance alone in patients with thyroid incidentaloma measuring 1–2 cm

  • Carlos K. H. WongEmail author
  • Brian H. H. Lang
Original Article



To present the impact of treatment on health-related quality-of-life (HRQOL) and health utility measures from the randomized controlled trial ( Identifier: NCT02398721) that investigated the FNAC versus watchful surveillance in patients with incidental benign thyroid nodules.


Health utility and HRQOL were evaluated using the EQ-5D 5-level (EQ-5D-5L), 6-item Short-Form Health Survey (SF-6D), and generic 12-item Short-Form Health Survey (SF-12v2) at baseline, 3-month, 6-month, and 12-month assessments. A repeated measure analysis of variance evaluated differences in HRQOL scores between treatment groups over time. Multiple imputations were used to impute missing data at each time point.


HRQOL data completion rates were 99.7% at baseline, 92.7% at 3-month, 93.9% at 6-month, 92.7% at 12-month, and 88.6% at 18-month follow-up after baseline. There were significant mean differences in SF-6D, EQ-5D-5L, and SF-12v2 over time except the domain of vitality and mental health of SF-12v2. Mean change of SF-12v2 scores and utility scores from baseline between groups did not exceed minimal important difference. No significant treatment group by time interactions were found in all HRQOL and utility scores except in the vitality domain and PCS of SF-12v2 (p value = 0.033; 0.024).


When compared with watchful surveillance, FNAC intervention was associated with better vitality and physical-related HRQOL scores but did not provide better preservation of utility score improvement over the 18-month period. These findings support the routine FNAC approach for nodules that have a low-suspicion sonographic pattern and measure between 1.0 and 2.0 cm.


Quality-of-life Thyroid nodules Chinese Randomized controlled trial FNAC 



The research team would like to express our greatest gratitude to Ms. LI Wing Kar and Mr. YU Ming-Sing for coordinating data collection and conducting data analysis. Special thanks to Ms. LIU Xiaodong for the support.


This study has been funded by the Health and Medical Research Fund, Food and Health Bureau, HKSAR (Ref. no 12132941). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

12020_2019_2129_MOESM1_ESM.docx (17.8 mb)
Supplementary Information


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Family Medicine and Primary Care, Li Ka Shing Faculty of MedicineThe University of Hong KongHong Kong SARChina
  2. 2.Division of Endocrine Surgery, Department of Surgery, Li Ka Shing Faculty of MedicineThe University of Hong KongHong Kong SARChina

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