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

Published online by Cambridge University Press:  17 October 2013

C Burgess ,
L Dias ,
E Maughan  and
R Moorthy
C Burgess*
Affiliation:
ENT Department, Wexham Park Hospital, UK
L Dias
Affiliation:
ENT Department, Wexham Park Hospital, UK
E Maughan
Affiliation:
ENT Department, Wexham Park Hospital, UK
R Moorthy
Affiliation:
ENT Department, Wexham Park Hospital, UK
*
Address for correspondence: Mr C Burgess, ENT Department, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK Fax: 01865 231200 E-mail: chris.burgess@doctors.org.uk
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Abstract

Objectives:

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.

Keywords

NeckBiopsy, Fine-NeedleUltrasonographyCost-Benefit Analysis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 11 , November 2013 , pp. 1122 - 1126
Copyright
Copyright © JLO (1984) Limited 2013 

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Footnotes

Presented as a poster at the British Academic Conference of Otolaryngologists, 6 July 2012, Glasgow, Scotland, UK.

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