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Endocrine

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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
  • 52 Downloads

Abstract

Purpose

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

Methods

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.

Results

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).

Conclusions

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.

Keywords

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

Notes

Acknowledgements

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.

Funding

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

References

  1. 1.
    S. Ezzat et al. Thyroid incidentalomas: prevalence by palpation and ultrasonography. Arch. Intern. Med. 154(16), 1838–1840 (1994)CrossRefGoogle Scholar
  2. 2.
    D.S. Dean, H. Gharib, Epidemiology of thyroid nodules. Best. Pract. Res. Clin. Endocrinol. Metab. 22(6), 901–911 (2008)CrossRefGoogle Scholar
  3. 3.
    D.S. Ross, Nonpalpable thyroid nodules–managing an epidemic. J. Clin. Endocrinol. Metab. 87(5), 1938–1940 (2002)PubMedGoogle Scholar
  4. 4.
    G. Russ, Risk stratification of thyroid nodules on ultrasonography with the French TI-RADS: description and reflections. Ultrasonography 35(1), 25–38 (2016)CrossRefGoogle Scholar
  5. 5.
    S. Leboulleux et al. Frequency and intensity of pain related to thyroid nodule fine-needle aspiration cytology. Thyroid 23(9), 1113–1118 (2013)CrossRefGoogle Scholar
  6. 6.
    B.R. Haugen et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 26(1), 1–133 (2016)CrossRefGoogle Scholar
  7. 7.
    L. Lodewijk et al. Same-day fine-needle aspiration cytology diagnosis for thyroid nodules achieves rapid anxiety decrease and high diagnostic accuracy. Endocr. Pract. 22(5), 561–566 (2016)CrossRefGoogle Scholar
  8. 8.
    C.K.H. Wong et al. EQ-5D-5L and SF-6D utility measures in symptomatic benign thyroid nodules: acceptability and psychometric evaluation. Patient 10(4), 447–454 (2017)CrossRefGoogle Scholar
  9. 9.
    P. Wang et al. The EQ-5D-5L is more discriminative than the EQ-5D-3L in patients with diabetes in Singapore. Value Health Reg. Issues 9, 57–62 (2016)CrossRefGoogle Scholar
  10. 10.
    P.W.H. Cheung et al. Psychometric validation of the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) in Chinese patients with adolescent idiopathic scoliosis. Scoliosis Spinal Disord. 11, 19 (2016)CrossRefGoogle Scholar
  11. 11.
    C.-W. Pan et al. Valuing health-related quality of life in type 2 diabetes patients in China. Med. Decis. Mak. 36(2), 234–241 (2016)CrossRefGoogle Scholar
  12. 12.
    B. van Hout et al. Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health 15(5), 708–715 (2012)CrossRefGoogle Scholar
  13. 13.
    G.G. Liu et al. Chinese time trade-off values for EQ-5D health states. Value Health 17(5), 597–604 (2014)CrossRefGoogle Scholar
  14. 14.
    N.S. McClure et al. Instrument-defined estimates of the minimally important difference for EQ-5D-5L index scores. Value Health 20(4), 644–650 (2017)CrossRefGoogle Scholar
  15. 15.
    J.E. Brazier, J. Roberts, The estimation of a preference-based measure of health from the SF-12. Med. Care 42(9), 851–859 (2004)CrossRefGoogle Scholar
  16. 16.
    C.L.K. Lam, J. Brazier, S.M. McGhee, Valuation of the SF-6D health states is feasible, acceptable, reliable, and valid in a chinese population. Value Health 11(2), 295–303 (2008)CrossRefGoogle Scholar
  17. 17.
    S.M. McGhee et al. Quality-adjusted life years: population-specific measurement of the quality component. Hong. Kong Med. J. 17(Suppl 6), 17–21 (2011)PubMedGoogle Scholar
  18. 18.
    S.J. Walters, J.E. Brazier, Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual. Life Res. 14(6), 1523–1532 (2005)CrossRefGoogle Scholar
  19. 19.
    C.K. Wong, E.T. Lam, C.L. Lam, Comparison of direct-measured and derived short form six dimensions (SF-6D) health preference values among chronic hepatitis B patients. Qual. Life Res. 22(10), 2973–2981 (2013)CrossRefGoogle Scholar

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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