Having achieved these results, it is important to point out that cost-effectiveness studies, like any study have inherent problems with them, said Dr. Shrime. Assumptions, even if they are lessened somewhat by sensitivity analyses, are made and may still bias results in one way or another.
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July 2007I think cost-effectiveness studies are only an indication of possibly what should be done, added Dr. Shrime. I don’t think they are the ultimate arbiter of the way medicine should be practiced, nor do they necessarily reflect the actual practice patterns in place.
I do think it’s a significant finding that total thyroidectomy dominates these calculations and I think it should give people pause, even if it ends up being that hemithyroidectomy, given the way physicians actually practice, rather than the idealized consensus recommendations, becomes more cost-effective. But I don’t think physicians should end up basing all their decisions on costs. What they should do, instead, is prod the community to undertake the stronger, but harder to do, randomized controlled trials.
Reference
- Jemal A, Murray T, et al. Cancer statistics, 2005. CA Cancer J Clin 2005 Jan-Feb;55(1):10-30. Erratum in: CA Cancer J Clin 2005 Jul-Aug;55(4):259.
©2007 The Triological Society
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