Routine on-site evaluation of specimen adequacy during initial ultrasound-guided fine needle aspiration of thyroid nodules: a cost-effectiveness analysis.

Background: On-site evaluation (OSE) of specimen adequacy during fine needle aspiration (FNA) of thyroid nodules reduces unsatisfactory results but adds cost. We hypothesized that the addition of routine OSE to initial ultrasound-guided FNA of thyroid nodules is not cost-effective.

Methods: Formal cost-effectiveness analysis was performed using a decision model to compare strategies of routine initial OSE versus restriction of OSE to cases of prior inadequate FNA.