{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T01:45:34Z","timestamp":1783647934096,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,8,22]],"date-time":"2017-08-22T00:00:00Z","timestamp":1503360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To predict the cost\u2010effectiveness of implementing routine gene expression classifier testing for thyroid nodules with indeterminate fine\u2010needle aspiration cytology, by utilizing a real cohort of patients as a comparator.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cost\u2010effectiveness analysis of a retrospective cohort compared with a simulated cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>We reviewed the records of all patients who underwent ultrasound\u2010guided fine\u2010needle aspiration from 2010 to 2014 at a tertiary academic medical center. All patients with Bethesda class III or IV cytopathology had the details of their management catalogued over the subsequent 2 years of care. These patients were assigned to the standard\u2010of\u2010care arm of the study. We compared the third\u2010party payer costs of care and the proportion of patients who underwent surgery with a simulated cohort who underwent gene expression classifier testing after an initial indeterminate fine\u2010needle aspiration (molecular test arm).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cost of managing 1\u00a0nodule over 2 years was $2399 higher (range, $397\u2010$4399) for the molecular test group than the standard of care group. The molecular test group had a 13.1% decrease (base parameters; range, 0.73%\u201045.09%) in the number of patients undergoing surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When applied to a real cohort of patients, routine gene expression classifier is predicted to reduce the number of patients undergoing surgery but will increase cost of care. Cost\u2010effectiveness is heavily dependent on prevalence of malignancy and gene expression classifier specificity.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817725709","type":"journal-article","created":{"date-parts":[[2017,8,22]],"date-time":"2017-08-22T08:19:15Z","timestamp":1503389955000},"page":"596-601","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Cost\u2010effectiveness of Gene Expression Classifier Testing of Indeterminate Thyroid Nodules Utilizing a Real Cohort Comparator"],"prefix":"10.1002","volume":"157","author":[{"given":"Scott","family":"Shapiro","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery West Virginia University Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed","family":"Pharaon","sequence":"additional","affiliation":[{"name":"Department of Pathology West Virginia University Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Kellermeyer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery West Virginia University Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPPHLWMI3JV4LA"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339959"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1586\/14737159.2013.811893"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1203208"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0459"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13096"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1219"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0502"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-1082"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000333274"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2010-0156"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.0850"},{"key":"e_1_2_8_15_1","first-page":"219","article-title":"Intraoperative assessment of thyroid and parathyroid lesions","volume":"19","author":"Baloch ZW","year":"2002","journal-title":"Semin Diagn Pathol"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200105000-00016"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.05.027"},{"key":"e_1_2_8_18_1","unstructured":"Centers for Medicare & Medicaid Services.Medicare reimbursement schedule.http:\/\/www.cmc.gov. Accessed December 10 2016."},{"key":"e_1_2_8_19_1","unstructured":"Agency for Healtcare and Research Quality.Overview of the nationwide inpatient sample from the healthcare cost and utilization project.http:\/\/www.hcup\u2010us.ahrq.gov. Accessed December 11 2016."}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599817725709","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599817725709","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599817725709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:54:06Z","timestamp":1760954046000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599817725709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,22]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1177\/0194599817725709"],"URL":"https:\/\/doi.org\/10.1177\/0194599817725709","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,22]]},"assertion":[{"value":"2017-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}