Abstract：
BACKGROUND: Percutaneous ethanol injection (PEI) has been shown to be a valuable treatment for thyroid nodular pathology and metastatic cervical adenopathies.
OBJECTIVE: To evaluate the effectiveness, safety, and cost-effectiveness of PEI in thyroid nodular pathology and metastatic cervical adenopathies.
METHODS: A systematic review (SR) using meta-analysis was conducted on the effectiveness and safety of PEI. A SR on cost-effectiveness was also performed. The SRs were conducted according to the methodology developed by the Cochrane Collaboration with reporting in accordance with the PRISMA statement. A cost-minimization analysis was carried out using a decision tree model. Assuming equal effectiveness between two minimally invasive techniques (PEI and radiofrequency ablation (RFA)), the model compared the costs of the alternatives with a horizon of six months and from the perspective of the Spanish National Health System.
RESULTS: The search identified three RCTs (n=157) that evaluated PEI versus RFA in patients diagnosed with benign thyroid nodules: ninety-six patients with predominantly cystic nodules and sixty-one patients with solid nodules. No evidence was found on other techniques or thyroid nodular pathology. No statistically significant differences were observed between PEI and RFA in volume reduction (%), symptom score, cosmetic score, therapeutic success and major complications. No economic evaluations were identified. The cost-minimization analysis estimated the cost per patient of the PEI procedure at €326 compared to €4781 for RFA, which means an incremental difference of -€4455.
CONCLUSIONS: There are no differences between PEI and RFA regarding their safety and effectiveness, but the economic evaluation determined that the former option is cheaper.
OBJECTIVE: To evaluate the effectiveness, safety, and cost-effectiveness of PEI in thyroid nodular pathology and metastatic cervical adenopathies.
METHODS: A systematic review (SR) using meta-analysis was conducted on the effectiveness and safety of PEI. A SR on cost-effectiveness was also performed. The SRs were conducted according to the methodology developed by the Cochrane Collaboration with reporting in accordance with the PRISMA statement. A cost-minimization analysis was carried out using a decision tree model. Assuming equal effectiveness between two minimally invasive techniques (PEI and radiofrequency ablation (RFA)), the model compared the costs of the alternatives with a horizon of six months and from the perspective of the Spanish National Health System.
RESULTS: The search identified three RCTs (n=157) that evaluated PEI versus RFA in patients diagnosed with benign thyroid nodules: ninety-six patients with predominantly cystic nodules and sixty-one patients with solid nodules. No evidence was found on other techniques or thyroid nodular pathology. No statistically significant differences were observed between PEI and RFA in volume reduction (%), symptom score, cosmetic score, therapeutic success and major complications. No economic evaluations were identified. The cost-minimization analysis estimated the cost per patient of the PEI procedure at €326 compared to €4781 for RFA, which means an incremental difference of -€4455.
CONCLUSIONS: There are no differences between PEI and RFA regarding their safety and effectiveness, but the economic evaluation determined that the former option is cheaper.
摘要：
背景：经皮乙醇注射（PEI）已被证明是甲状腺结节病理和转移性宫颈腺病的有价值的治疗方法。
目的：为了评估有效性，安全,PEI在甲状腺结节病理和转移性宫颈腺病中的成本效益。
方法：使用荟萃分析对PEI的有效性和安全性进行了系统评价（SR）。还进行了关于成本效益的SR。SRs是根据CochraneCollaboration制定的方法进行的，并根据PRISMA声明进行报告。使用决策树模型进行了成本最小化分析。假设两种微创技术（PEI和射频消融（RFA））的有效性相同，该模型从西班牙国家卫生系统的角度比较了六个月替代方案的成本。
结果：搜索确定了三个RCT（n=157），用于评估诊断为良性甲状腺结节的患者的PEI和RFA：96例主要为囊性结节的患者和61例实性结节的患者。没有发现其他技术或甲状腺结节病理学的证据。PEI和RFA在体积减少(%)方面没有观察到统计学上的显著差异,症状评分,化妆品评分,治疗成功和主要并发症。没有确定经济评估。成本最小化分析估计PEI手术每位患者的成本为326欧元，而RFA为4781欧元。这意味着-4455欧元的增量差额。
结论：PEI和RFA在安全性和有效性方面没有差异，但是经济评估确定前一种选择更便宜。
目的：为了评估有效性，安全,PEI在甲状腺结节病理和转移性宫颈腺病中的成本效益。
方法：使用荟萃分析对PEI的有效性和安全性进行了系统评价（SR）。还进行了关于成本效益的SR。SRs是根据CochraneCollaboration制定的方法进行的，并根据PRISMA声明进行报告。使用决策树模型进行了成本最小化分析。假设两种微创技术（PEI和射频消融（RFA））的有效性相同，该模型从西班牙国家卫生系统的角度比较了六个月替代方案的成本。
结果：搜索确定了三个RCT（n=157），用于评估诊断为良性甲状腺结节的患者的PEI和RFA：96例主要为囊性结节的患者和61例实性结节的患者。没有发现其他技术或甲状腺结节病理学的证据。PEI和RFA在体积减少(%)方面没有观察到统计学上的显著差异,症状评分,化妆品评分,治疗成功和主要并发症。没有确定经济评估。成本最小化分析估计PEI手术每位患者的成本为326欧元，而RFA为4781欧元。这意味着-4455欧元的增量差额。
结论：PEI和RFA在安全性和有效性方面没有差异，但是经济评估确定前一种选择更便宜。
