Neck lump clinics: is on-site assessment of fine needle aspirate diagnostic adequacy cost-effective?

Journal of Laryngology and Otology - Tập 127 Số 11 - Trang 1122-1126 - 2013
Christopher Burgess1, L Dias2, Elizabeth Maughan2, Ram Moorthy2
1ENT Department, Wexham Park Hospital, UK.
2Wexham Park Hospital

Tóm tắt

AbstractObjectives:

To establish the diagnostic adequacy of ultrasound-guided fine needle aspiration cytology samples at the East Berkshire neck lump clinic, and to perform a cost-benefit analysis related to the hypothetical addition of an on-site cytology technician (required to review fine needle aspiration specimen adequacy).

Method:

The adequacy of all ultrasound-guided fine needle aspiration procedures was reviewed from 1 January to 30 June 2011. These results were used in the cost-benefit analysis related to on-site cytology assessment.

Results:

Of the 307 ultrasound-guided fine needle aspiration cytology procedures performed over 6 months, 67 (22 per cent) were reported to be non-diagnostic. Operator experience was found to correlate significantly with diagnostic adequacy (p < 0.001). Only 5 per cent of all fine needle aspirations were initially non-diagnostic but diagnostic on repeat sampling. This suggests that the financial and time costs of on-site fine needle aspirate adequacy assessment would outweigh any benefit.

Conclusion:

In this series, the experience of individuals performing fine needle aspirations was the most important factor related to adequacy.

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Tài liệu tham khảo

10.1007/s003300000540

10.1017/S0022215109992635

10.1148/radiol.2222010201

Payment by Results 2010–2011 National Tariff Information. In: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_113900.xls [25 March 2012]

10.1016/0301-5629(96)00038-5

10.1259/0007-1285-68-807-266

2004, Guidance on Cancer Services: Improving Outcomes in Head and Neck Cancers

10.1017/S0022215106004944

10.1002/cncr.21715

10.1016/j.ejrad.2007.05.016

10.1309/XLNDTE289WAQYK0Y

Ganguly, 2010, The benefits of on-site cytology with ultrasound-guided fine needle aspiration in a one-stop neck lump clinic, Ann R Coll Surg Engl, 92, 660

10.1017/S002221510014246X