Does the Adoption of Molecular Testing Cause Decreased Thyroidectomy Rates in a National Cohort? A Quasiexperimental Study of High- Versus Low-Adoption States
Main finding · Thyroidectomy ratesResult — go to the resultAdjusted DID rate −3.3% CI −5.6% to −0.8%Authors' conclusion
Although thyroidectomy rates were inversely correlated with MT utilization, our study suggests that this correlation is not causal.
Study context
- Population
- US adults who underwent thyroid fine-needle aspiration (FNA), 2011–2021, MarketScan Research Databases
- Participants
- 471,364 adults
- Exposure
- High-adoption vs low-adoption states of molecular testing
- Outcome
- Effect of MT adoption on thyroidectomy rates (difference-in-differences)
- Follow-up
- 2015 to 2021
Methodological detailsquasiexperimental, national claims database (Merative MarketScan), interrupted time series analysis, difference-in-differences analysis
- Quasiexperimental
- National claims database (Merative MarketScan)
- Interrupted time series analysis
- Difference-in-differences analysis
Main finding
Thyroidectomy rates
Adjusted difference-in-differences (DID) rate
−3.3%
CI −5.6% to −0.8%
By group
High-adoption states
15.9-13.4%
Low-adoption states
18.5-13.2%
Low-adoption statesvs High-adoption states
adjusted DID rate −3.3% (CI −5.6% to −0.8%)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | High-adoption states | Low-adoption states |
|---|---|---|
| Average MT utilization rate · 2015 to 2021 | 2.4% to 15.3% | 1.6% to 5.6% |
Molecular testing (MT) utilization overall · 2011 to 2021
- MT utilization increased from
- 0.01% [CI: 0.00% to 0.02%]
- MT utilization in 2021
- 10.1% [CI: 9.7% to 10.5%]
- Immediate increase in MT adoption after 2015
- β2 = 1.61, p = 0.002
- Deeper increase in MT adoption after 2015
- β3 = 0.6, p < 0.001
- Interrupted time series analysis
MT utilization by patient characteristics
- MT utilization lower in black patients, the elderly, rural areas and patients with Medicaid
- P < 0.05
Correlation of thyroidectomy rates with MT utilization
- Inverse correlation
- r = −0.98, p < 0.0001
Original publication
Does the Adoption of Molecular Testing Cause Decreased Thyroidectomy Rates in a National Cohort? A Quasiexperimental Study of High- Versus Low-Adoption States. Thyroid. Published 22 January 2024. doi:10.
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