When Is Rapid On-Site Evaluation Cost-Effective for Fine-Needle Aspiration Biopsy?

PloS One
Robert L SchmidtMichael B Cohen

Abstract

Rapid on-site evaluation (ROSE) can improve adequacy rates of fine-needle aspiration biopsy (FNAB) but increases operational costs. The performance of ROSE relative to fixed sampling depends on many factors. It is not clear when ROSE is less costly than sampling with a fixed number of needle passes. The objective of this study was to determine the conditions under which ROSE is less costly than fixed sampling. Cost comparison of sampling with and without ROSE using mathematical modeling. Models were based on a societal perspective and used a mechanistic, micro-costing approach. Sampling policies (ROSE, fixed) were compared using the difference in total expected costs per case. Scenarios were based on procedure complexity (palpation-guided or image-guided), adequacy rates (low, high) and sampling protocols (stopping criteria for ROSE and fixed sampling). One-way, probabilistic, and scenario-based sensitivity analysis was performed to determine which variables had the greatest influence on the cost difference. ROSE is favored relative to fixed sampling under the following conditions: (1) the cytologist is accurate, (2) the total variable cost ($/hr) is low, (3) fixed costs ($/procedure) are high, (4) the setup time is long, (5) t...Continue Reading

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Citations

Jun 14, 2017·Cancer Cytopathology·Adele O Kraft
Aug 25, 2018·Archives of Pathology & Laboratory Medicine·Muneezeh LiaqatImran Mirza
Jan 28, 2020·Cytopathology : Official Journal of the British Society for Clinical Cytology·Juan XingLiron Pantanowitz
Feb 2, 2020·Surgical Pathology Clinics·Jian Jing, Kristine E Konopka

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Methods Mentioned

BETA
biopsy

Software Mentioned

ROSE
Stata

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