Publicly Funded Molecular Testing of Indeterminate Thyroid Nodules: Canada's Experience
Authors' conclusion
The use of MT (TSv3) in a well-selected population with ITNs led to a BCR of 72.6%. It is cost-effective and prevents unnecessary surgeries in a public health care setting.
Study context
- Population
- Consecutive patients with Bethesda III (on 2 consecutive cytopathologies) or IV and TIRADS 3 or 4 thyroid nodules measuring 1 to 4 cm, 5 academic centers in Quebec, Canada
- Participants
- 500 consecutive patients
- Outcome
- Benign call rate (BCR): proportion of indeterminate thyroid nodules (ITNs) with negative TSv3 results
Methodological detailsmulticentric, real-world practice, 5 academic centers, molecular testing (MT) performed between November 2021 and November 2022, Positive ThyroSeq v3 (TSv3) referred for surgery; negative TSv3 planned for US follow-up for a minimum of 2 years
- Multicentric
- Real-world practice
- 5 academic centers
- MT performed between November 2021 and November 2022
- Positive TSv3 referred for surgery; negative TSv3 planned for US follow-up for a minimum of 2 years
Main finding
As reported in the abstract
BCR
TSv3
72.6%
CI 68.5%–76.5%
- P value
- P < 0.001
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Values |
|---|---|
| Patients with negative result who avoided surgery | TSv3 99.7% |
| PPV of TSv3 | TSv3 PPV 68.2% · 95% CI 58.5%-76.9% |
Cost-benefit analysis · next 10 years
- Cost savings with implementation of MT
- $6.1 million
Original publication
Publicly Funded Molecular Testing of Indeterminate Thyroid Nodules: Canada's Experience. J Clin Endocrinol Metab. Published 23 May 2024. doi:10.
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