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stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style"><div class="fm-sec bkr_bottom_sep"><div class="bkr_thumb"><a href="https://www.nice.org.uk" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng145er16-lrg.png" alt="Cover of Management of non-malignant thyroid enlargement" /></a></div><div class="bkr_bib"><h1 id="_NBK577222_"><span itemprop="name">Management of non-malignant thyroid enlargement</span></h1><div class="subtitle">Thyroid disease: assessment and management</div><p><b>Evidence review P</b></p><p><i>NICE Guideline, No. 145</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Centre (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2019 Nov</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3595-6</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div></div><div class="bkr_clear"></div></div><div id="ch16.s1"><h2 id="_ch16_s1_">1. Management of thyroid enlargement</h2><div id="ch16.s1.1"><h3>1.1. Review question: Which people with non-malignant thyroid enlargement should be referred for surgery?</h3><div id="ch16.s1.2"><h4>Review question: What is the clinical and cost effectiveness of non-surgical treatments (for example radiofrequency ablation, high intensity focused ultrasound(HIFU)) for non-malignant thyroid enlargement?</h4></div></div><div id="ch16.s1.3"><h3>1.2. Introduction</h3><p>In many patients, thyroid enlargement requires no surgical intervention and may be managed according to the patients’ thyroid function. Thyroidectomy may be performed in the management of non-malignant thyroid disease. Recognised indications for surgery include patient preference, failed medical management (in the context of concomitantly deranged thyroid function), mass effect and cosmetic embarrassment. Careful discussion is warranted to ensure patients understand the sequelae and risks of surgery, which will differ with the extent of the operation. Robot assisted surgery remains uncommon in the UK.</p><p>In recent years percutaneous ablation techniques have been used in the treatment of thyroid malignancies, with many of these deriving from ablation of other solid organ tumours. Techniques include radiofrequency ablation, microwave ablation, laser ablation, and high intensity focused ultrasound. Ethanol ablation has also been described but tends to be used in the ablation of thyroid cysts when aspiration has failed. The use of percutaneous ablation by any method in the management of benign disease is a new, but growing, development and is gaining traction in centres across the UK. This review, whilst recognising the novelty of these applications in non-malignant thyroid disease, seeks to assess the current evidence for them whilst also outlining the situations in which surgical (and by extension these nonsurgical percutaneous alternatives) treatment is warranted.</p></div><div id="ch16.s1.4"><h3>1.3. PICO table</h3><p>For full details see the review protocol in <a href="#ch16.appa">Appendix A</a>:.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab1"><a href="/books/NBK577222/table/ch16.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab1" rid-ob="figobch16tab1"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab1/?report=thumb" src-large="/books/NBK577222/table/ch16.tab1/?report=previmg" alt="Table 1. PICO characteristics of review question." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab1"><a href="/books/NBK577222/table/ch16.tab1/?report=objectonly" target="object" rid-ob="figobch16tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of review question. </p></div></div></div><div id="ch16.s1.5"><h3>1.4. Clinical evidence</h3><div id="ch16.s1.5.1"><h4>1.4.1. Included studies</h4><p>Twenty studies were included in the review;<a class="bibr" href="#ch16.ref1" rid="ch16.ref1"><sup>1</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref5" rid="ch16.ref5"><sup>5</sup></a><sup>–</sup><a class="bibr" href="#ch16.ref8" rid="ch16.ref8"><sup>8</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref13" rid="ch16.ref13"><sup>13</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref21" rid="ch16.ref21"><sup>21</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref24" rid="ch16.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref34" rid="ch16.ref34"><sup>34</sup></a><sup>–</sup><a class="bibr" href="#ch16.ref36" rid="ch16.ref36"><sup>36</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref39" rid="ch16.ref39"><sup>39</sup></a><sup>–</sup><a class="bibr" href="#ch16.ref42" rid="ch16.ref42"><sup>42</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref45" rid="ch16.ref45"><sup>45</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref48" rid="ch16.ref48"><sup>48</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref50" rid="ch16.ref50"><sup>50</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref53" rid="ch16.ref53"><sup>53</sup></a><sup>,</sup>
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<a class="bibr" href="#ch16.ref54" rid="ch16.ref54"><sup>54</sup></a> these are summarised in <a class="figpopup" href="/books/NBK577222/table/ch16.tab2/?report=objectonly" target="object" rid-figpopup="figch16tab2" rid-ob="figobch16tab2">Table 2</a> below. Evidence from these studies is summarised in the clinical evidence summary below (<a class="figpopup" href="/books/NBK577222/table/ch16.tab3/?report=objectonly" target="object" rid-figpopup="figch16tab3" rid-ob="figobch16tab3">Table 3</a>).</p><p>One Cochrane review in this area was identified<a class="bibr" href="#ch16.ref3" rid="ch16.ref3"><sup>3</sup></a>, the studies included in this review were checked against the protocol and included as appropriate.</p><p>All studies were in adults (between 18 and 65).</p><p>Eleven RCTs were found comparing levothyroxine with either placebo or follow-up only, in people with non-cystic nodules. Two RCTs were found comparing radiofrequency ablation with follow-up only, in people with non-cystic nodules. One RCT was found with three arms comparing levothyroxine, laser ablation and follow-up only in people with non-cystic nodules. One RCT was found comparing ethanol ablation, with levothyroxine in people with non-cystic nodules. One RCT was found comparing microwave ablation with surgery. Two RCTs were found comparing radiofrequency ablation with ethanol ablation, in people with cystic nodules.</p><p>One non-randomised study was found comparing radiofrequency ablation with surgery, in people with non-specified types of nodules. One non-randomised study compared HIFU with surgery in people with non-cystic nodules.</p><p>No evidence was found comparing radioactive iodine ablation with any other intervention. No evidence was found comparing surgery or ethanol ablation with a non-active intervention.</p><p>See also the study selection flow chart in <a href="#ch16.appc">Appendix C</a>:, study evidence tables in <a href="#ch16.appd">Appendix D</a>:, forest plots in <a href="#ch16.appe">Appendix E</a>: and GRADE tables in <a href="#ch16.appf">Appendix F</a>:.</p></div><div id="ch16.s1.5.2"><h4>1.4.2. Excluded studies</h4><p>See the excluded studies list in <a href="#ch16.appj">Appendix J</a>:.</p></div><div id="ch16.s1.5.3"><h4>1.4.3. Summary of clinical studies included in the evidence review</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab2"><a href="/books/NBK577222/table/ch16.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab2" rid-ob="figobch16tab2"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab2/?report=thumb" src-large="/books/NBK577222/table/ch16.tab2/?report=previmg" alt="Table 2. Summary of studies included in the evidence review." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab2"><a href="/books/NBK577222/table/ch16.tab2/?report=objectonly" target="object" rid-ob="figobch16tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the evidence review. </p></div></div><p>See <a href="#ch16.appd">Appendix D</a>: for full evidence tables.</p></div><div id="ch16.s1.5.4"><h4>1.4.4. Quality assessment of clinical studies included in the evidence review</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab3"><a href="/books/NBK577222/table/ch16.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab3" rid-ob="figobch16tab3"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab3/?report=thumb" src-large="/books/NBK577222/table/ch16.tab3/?report=previmg" alt="Table 3. Clinical evidence summary: Levothyroxine vs placebo/follow-up only, non-cystic nodules." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab3"><a href="/books/NBK577222/table/ch16.tab3/?report=objectonly" target="object" rid-ob="figobch16tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Levothyroxine vs placebo/follow-up only, non-cystic nodules. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab4"><a href="/books/NBK577222/table/ch16.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab4" rid-ob="figobch16tab4"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab4/?report=thumb" src-large="/books/NBK577222/table/ch16.tab4/?report=previmg" alt="Table 4. Clinical evidence summary: Radiofrequency ablation vs follow-up only, non-cystic nodules." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab4"><a href="/books/NBK577222/table/ch16.tab4/?report=objectonly" target="object" rid-ob="figobch16tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Radiofrequency ablation vs follow-up only, non-cystic nodules. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab5"><a href="/books/NBK577222/table/ch16.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab5" rid-ob="figobch16tab5"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab5/?report=thumb" src-large="/books/NBK577222/table/ch16.tab5/?report=previmg" alt="Table 5. Clinical evidence summary: Laser ablation vs follow-up only, non-cystic nodules." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab5"><a href="/books/NBK577222/table/ch16.tab5/?report=objectonly" target="object" rid-ob="figobch16tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Laser ablation vs follow-up only, non-cystic nodules. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab6"><a href="/books/NBK577222/table/ch16.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab6" rid-ob="figobch16tab6"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab6/?report=thumb" src-large="/books/NBK577222/table/ch16.tab6/?report=previmg" alt="Table 6. Clinical evidence summary: Laser ablation vs levothyroxine, non-cystic nodules." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab6"><a href="/books/NBK577222/table/ch16.tab6/?report=objectonly" target="object" rid-ob="figobch16tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Laser ablation vs levothyroxine, non-cystic nodules. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab7"><a href="/books/NBK577222/table/ch16.tab7/?report=objectonly" target="object" title="Table 7" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab7" rid-ob="figobch16tab7"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab7/?report=thumb" src-large="/books/NBK577222/table/ch16.tab7/?report=previmg" alt="Table 7. Clinical evidence summary: Percutaneous ethanol injection vs levothyroxine, non-cystic nodules." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab7"><a href="/books/NBK577222/table/ch16.tab7/?report=objectonly" target="object" rid-ob="figobch16tab7">Table 7</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Percutaneous ethanol injection vs levothyroxine, non-cystic nodules. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab8"><a href="/books/NBK577222/table/ch16.tab8/?report=objectonly" target="object" title="Table 8" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab8" rid-ob="figobch16tab8"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab8/?report=thumb" src-large="/books/NBK577222/table/ch16.tab8/?report=previmg" alt="Table 8. Clinical evidence summary: HIFU vs surgery, non-cystic nodules, NRS." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab8"><a href="/books/NBK577222/table/ch16.tab8/?report=objectonly" target="object" rid-ob="figobch16tab8">Table 8</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: HIFU vs surgery, non-cystic nodules, NRS. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab9"><a href="/books/NBK577222/table/ch16.tab9/?report=objectonly" target="object" title="Table 9" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab9" rid-ob="figobch16tab9"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab9/?report=thumb" src-large="/books/NBK577222/table/ch16.tab9/?report=previmg" alt="Table 9. Clinical evidence summary: Radiofrequency ablation vs percutaneous ethanol injection, cystic nodules." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab9"><a href="/books/NBK577222/table/ch16.tab9/?report=objectonly" target="object" rid-ob="figobch16tab9">Table 9</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Radiofrequency ablation vs percutaneous ethanol injection, cystic nodules. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab10"><a href="/books/NBK577222/table/ch16.tab10/?report=objectonly" target="object" title="Table 10" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab10" rid-ob="figobch16tab10"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab10/?report=thumb" src-large="/books/NBK577222/table/ch16.tab10/?report=previmg" alt="Table 10. Clinical evidence summary: Radiofrequency ablation vs surgery, nodule type unspecified, NRS." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab10"><a href="/books/NBK577222/table/ch16.tab10/?report=objectonly" target="object" rid-ob="figobch16tab10">Table 10</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Radiofrequency ablation vs surgery, nodule type unspecified, NRS. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab11"><a href="/books/NBK577222/table/ch16.tab11/?report=objectonly" target="object" title="Table 11" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab11" rid-ob="figobch16tab11"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab11/?report=thumb" src-large="/books/NBK577222/table/ch16.tab11/?report=previmg" alt="Table 11. Clinical evidence summary: Microwave ablation vs surgery, nodule type unspecified, RCT." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab11"><a href="/books/NBK577222/table/ch16.tab11/?report=objectonly" target="object" rid-ob="figobch16tab11">Table 11</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Microwave ablation vs surgery, nodule type unspecified, RCT. </p></div></div><p>See <a href="#ch16.appf">Appendix F</a>: for full GRADE tables.</p></div></div><div id="ch16.s1.6"><h3>1.5. Economic evidence</h3><div id="ch16.s1.6.1"><h4>1.5.1. Included studies</h4><p>No relevant health economic studies were identified.</p></div><div id="ch16.s1.6.2"><h4>1.5.2. Excluded studies</h4><p>No health economic studies that were relevant to this question were excluded due to assessment of limited applicability or methodological limitations.</p><p>See also the health economic study selection flow chart in <a href="#ch16.appg">Appendix G</a>:.</p></div><div id="ch16.s1.6.3"><h4>1.5.3. Health economic model</h4><p>This area was not prioritised for new cost-effectiveness analysis.</p></div><div id="ch16.s1.6.4"><h4>1.5.4. Resource costs</h4><p>Relevant unit costs are provided below to aid consideration of cost effectiveness.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab12"><a href="/books/NBK577222/table/ch16.tab12/?report=objectonly" target="object" title="Table 12" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab12" rid-ob="figobch16tab12"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab12/?report=thumb" src-large="/books/NBK577222/table/ch16.tab12/?report=previmg" alt="Table 12. UK costs of thyroid enlargement drugs." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab12"><a href="/books/NBK577222/table/ch16.tab12/?report=objectonly" target="object" rid-ob="figobch16tab12">Table 12</a></h4><p class="float-caption no_bottom_margin">UK costs of thyroid enlargement drugs. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16tab13"><a href="/books/NBK577222/table/ch16.tab13/?report=objectonly" target="object" title="Table 13" class="img_link icnblk_img figpopup" rid-figpopup="figch16tab13" rid-ob="figobch16tab13"><img class="small-thumb" src="/books/NBK577222/table/ch16.tab13/?report=thumb" src-large="/books/NBK577222/table/ch16.tab13/?report=previmg" alt="Table 13. UK costs of hospital procedures." /></a><div class="icnblk_cntnt"><h4 id="ch16.tab13"><a href="/books/NBK577222/table/ch16.tab13/?report=objectonly" target="object" rid-ob="figobch16tab13">Table 13</a></h4><p class="float-caption no_bottom_margin">UK costs of hospital procedures. </p></div></div></div></div><div id="ch16.s1.7"><h3>1.6. Evidence statements</h3><div id="ch16.s1.7.1"><h4>1.6.1. Clinical evidence statements</h4><div id="ch16.s1.7.1.1"><h5>1.6.1.1.1. Levothyroxine vs placebo/follow-up</h5><p>No clinically important difference was identified for nodule volume (ml, 11 studies, moderate quality), reduction in nodule volume (%, 1 study, high quality), hyperthyroidism (1 study, very low quality), arrhythmias (1 study, very low quality).</p><p>There was a clinically important benefit of levothyroxine for thyroid volume (1 study, moderate quality) and improvement in symptoms (1 study, very low quality).</p><p>No evidence identified for other outcomes.</p></div><div id="ch16.s1.7.1.2"><h5>1.6.1.1.2. Radiofrequency ablation vs follow-up only</h5><p>No clinically important difference was identified for hypothyroidism or hyperthyroidism (1 study, very low quality).</p><p>There was a clinically important benefit of radiofrequency ablation for nodule volume (2 studies, high quality) and compressive symptoms (2 studies, moderate quality).</p><p>No evidence identified for other outcomes.</p></div><div id="ch16.s1.7.1.3"><h5>1.6.1.1.3. Laser ablation vs follow-up only</h5><p>There was a clinically important benefit of laser ablation for nodule volume (1 study, moderate quality) and improvement in symptoms (1 study, very low quality).</p><p>No evidence identified for other outcomes.</p></div><div id="ch16.s1.7.1.4"><h5>1.6.1.1.4. Laser ablation vs levothyroxine</h5><p>No clinically important difference was identified for nodule volume (1 study, moderate quality).</p><p>There was a clinically important benefit of laser ablation for improvement in symptoms (1 study, low quality).</p><p>No evidence identified for other outcomes.</p></div><div id="ch16.s1.7.1.5"><h5>1.6.1.1.5. Ethanol injection vs levothyroxine</h5><p>No clinically important difference was identified for reduction in nodule volume (1 study, low quality).</p><p>There was a clinically important benefit of ethanol injection for compressive symptoms (1 study, low quality) and hyperthyroidism (1 study, low quality).</p><p>There was a clinically important harm of ethanol injection for pain on procedure (1 study, moderate quality).</p><p>No evidence identified for other outcomes.</p></div><div id="ch16.s1.7.1.6"><h5>1.6.1.1.6. HIFU vs surgery</h5><p>No clinically important difference was identified for reduction in nodule volume (1 study, low quality), hypothyroidism, RLN palsy, bleeding, infection, improvement in symptoms (1 study, very low quality).</p><p>No evidence identified for other outcomes.</p></div><div id="ch16.s1.7.1.7"><h5>1.6.1.1.7. Radiofrequency ablation vs ethanol injection</h5><p>No clinically important difference was identified for reduction in nodule volume (2 studies, moderate quality), compressive symptoms (2 studies, low quality).</p><p>There was a clinically important harm of radiofrequency ablation for pain (1 study, moderate quality).</p><p>No evidence identified for other outcomes.</p></div><div id="ch16.s1.7.1.8"><h5>1.6.1.1.8. Radiofrequency ablation vs surgery</h5><p>No clinically important difference was identified for quality of life – general health, mental health (1 study, very low quality).</p><p>There was a clinically important benefit of radiofrequency ablation for quality of life – vitality (1 study, very low quality).</p><p>No evidence identified for other outcomes.</p></div><div id="ch16.s1.7.1.9"><h5>1.6.1.1.9. Microwave ablation vs surgery</h5><p>No clinically important difference identified for reduction in nodule volume, hoarseness (1 study, very low quality), resolution of compressive symptoms (1 study, low quality).</p><p>There was a clinically important benefit of microwave ablation for post-operative pain (1 study, low quality).</p><p>No evidence identified for other outcomes.</p></div></div><div id="ch16.s1.7.2"><h4>1.6.2. Health economic evidence statements</h4><ul id="ch16.l3"><li id="ch16.lt16" class="half_rhythm"><div>No relevant economic evaluations were identified.</div></li></ul></div></div><div id="ch16.s1.8"><h3>1.7. The committee’s discussion of the evidence</h3><div id="ch16.s1.8.1"><h4>1.7.1. Interpreting the evidence</h4><div id="ch16.s1.8.1.1"><h5>1.7.1.1. The outcomes that matter most</h5><p>The committee agreed that the critical outcomes for this review were mortality and quality of life. Important outcomes included change in size of nodule/goitre, malignancy, hypothyroidism, hyperthyroidism, hypoparathyroidism, recurrent laryngeal nerve damage, bleeding, infection, arrhythmia, osteoporosis, pain, compressive symptoms and experience of care.</p></div><div id="ch16.s1.8.1.2"><h5>1.7.1.2. The quality of the evidence</h5><p>The majority of studies included in the review only reported on size of nodule. A few studies reported compressive symptoms and pain but there was little evidence on any other outcome. Thyroid dysfunction was reported occasionally but it was not always clear how this was defined or assayed.</p><p>There was no evidence on management of goitre.</p><p>The quality of the evidence in the review varied from very low to high quality. The levothyroxine vs placebo/follow-up comparison generally had the largest number of participants and the highest quality evidence, while the majority of other comparisons involved smaller numbers of participants.</p><p>The committee noted that the majority of studies did not specify the presence of symptoms as an inclusion criteria. However, because participants were typically recruited from specialty centres, referral to these centres was likely to be prompted by symptoms or cosmetic concerns.</p></div><div id="ch16.s1.8.1.3"><h5>1.7.1.3. Benefits and harms</h5><div id="ch16.s1.8.1.3.1"><h5>Levothyroxine</h5><p>The committee noted that there was no clinically important difference between levothyroxine and placebo/follow-up for the most commonly reported outcome of nodule volume. There was some evidence of benefit for compressive symptoms and thyroid volume as a whole, although these outcomes each came from single, smaller studies. Direct comparisons with other interventions (ethanol and laser ablation) showed a benefit for the other interventions on symptoms, although volume changes did not reach the level of clinical importance. The committee noted, based on their experience, that the long term use of levothyroxine is likely to be accompanied by adverse effects (for example TSH suppression). Overall the committee agreed that while there was insufficient evidence to strongly recommend against the use of levothyroxine, there was no evidence to support its use.</p></div><div id="ch16.s1.8.1.3.2"><h5>Ethanol ablation</h5><p>There was a clinically important benefit of ethanol ablation compared to levothyroxine in terms of compressive symptoms but no difference in reduction in nodule volume. This comparison was from a small study and the committee noted that the ethanol ablation did result in a greater nodule volume reduction, even if it did not reach the minimal important difference. Ethanol ablation resulted in people experiencing mild pain during the procedure but had a benefit compared with thyroxine in terms of people experiencing hyperthyroidism symptoms during the follow-up.</p></div><div id="ch16.s1.8.1.3.3"><h5>Percutaneous thermal ablation</h5><p>There was a clinically important benefit of radiofrequency ablation vs follow-up only in terms of nodule volume and compressive symptoms. There was no clinically important difference between RFA and ethanol ablation for volume or compressive symptoms and a clinically important harm of RFA vs ethanol ablation for mild pain during the procedure, although this was self-limiting. There was a clinically important benefit of radiofrequency ablation vs surgery in a non-randomised study for the quality of life vitality subscale, but no difference for any other quality of life subscale.</p><p>There was no clinically important difference between HIFU and surgery in terms of nodule volume, hypothyroidism, RLN palsy, bleeding, infection or improvement in symptoms.</p><p>There was no clinically important difference between microwave ablation and surgery in terms of nodule volume, hoarseness and resolution of compressive symptoms. Microwave ablation did have a clinically important benefit in terms of post-operative pain, however this was only temporary pain that resolved spontaneously with time.</p><p>There was a clinically important benefit of laser ablation for nodule volume and improvement in symptoms but only available from 1 study with very low quality evidence.</p><p>Overall the committee agreed that there may be a benefit from percutaneous thermal ablation techniques but that this is based on a small and generally low quality evidence base. Furthermore these techniques are not widely available in the UK. They agreed that they could be considered in some people with thyroid enlargement but that there was insufficient evidence to distinguish between the various options and that more research was required before a strong recommendation could be made or specific subgroups who may benefit most could be firmly identified.</p></div></div></div><div id="ch16.s1.8.2"><h4>1.7.2. Cost effectiveness and resource use</h4><p>There was no health economic evidence identified for either of the two-review question, therefore recommendations were based on consensus around the likely cost effectiveness of the interventions. Unit costs were presented for all the interventions considered to inform the qualitative considerations about cost effectiveness.</p><p>The recommendation made by the committee not to offer treatment to patients unless they have symptoms or there is clinical concern, is thought to be cost effective as only patients who need any type of treatment would then be considered. This can reduce the number of people receiving unnecessary treatment saving NHS money.</p><p>The committee made a consensus recommendation that treatment of children and young people should be discussed with an appropriate multidisciplinary team. The committee agreed this was important to ensure that appropriate management is agreed on as early as possible, preventing any deterioration in health or quality of life and, hence, ensuring the delivery of cost-effective care. However, the committee noted that, in general, thyroid enlargement is very rare in children and hence, small numbers will require such referral and this was seen to be current practice. Thus, the cost impact of this recommendation is likely to be minimal.</p><p>The committee recommended aspiration with possible ethanol ablation, as first line treatment for people with symptomatic cystic nodules, based on the clinical evidence and costs. The average cost of ethanol ablation was estimated to be £92, compared to radiofrequency ablation (RFA), which costs £734 (NHS reference cost code AB15Z). The committee did not recommend the use of RFA in this group of people as it was unlikely to be cost effective, same benefits as ethanol ablation and higher costs. However, the committee noted that percutaneous thermal ablation using either RFA or laser ablation should be considered in non-cystic nodule rather than ethanol ablation where there is a risk of ethanol leakage, which can cause complications. The committed considered the benefits from reducing the symptom burden and the likely complications and improving quality of life to justify the cost of providing thermal ablation.</p><p>The committee noted that for non-cystic nodule, multinodular goitre, or diffuse thyroid goitre causing compressive symptoms, radioactive iodine ablation, surgery or percutaneous thermal ablation (see above) should be considered. Radioactive iodine, costing £286 according to the NHS reference costs, should be considered where there is demonstrable radionuclide uptake, as first line. The use of radioactive iodine in this population reflects current practice; hence, unlikely to result in substantial cost impact. It was noted however, that there is uncertainty around the most appropriate dose of radioactive iodine to use in this population; hence, a research recommendation was also made.</p><p>The committee considered that for people with thyroid enlargement, who are contra-indicated or cannot tolerate the relevant interventions recommended above, referral for assessment for surgery should be considered. The committee discussed that despite the fact that surgery is more costly (approximately £4,265), it is likely to increase the patient’s quality of life and avoid downstream costs due to complications. Furthermore, repeat procedures are unlikely to be required. In addition, not all patients referred for assessments for surgery will have surgery the number is excepted to be small and most patients with no symptoms will not require any interventions. Given the small number requiring surgery, no significant resource impact is expected.</p></div><div id="ch16.s1.8.3"><h4>1.7.3. Other factors the committee took into account</h4><p>GPs may refer people to endocrinologists or directly to surgeons depending on local pathways available.</p><p>The committee noted that, based on their experience and the wider body of evidence not included in this review, larger nodules may require longer and more resource intensive interventions.</p><p>The committee noted that the cost of RFA includes the cost of the kits only as the machines are provided on a hiring agreement. There are capacity constraints on providing this intervention however, as there is only one centre in the UK that manages approximately 40 cases. Hence, the committee felt that including the option of laser ablation as another modality of thermal ablation can partly address the issue of access.</p></div></div></div><div id="ch16.rl.r1"><h2 id="_ch16_rl_r1_">References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="ch16.ref1">Baek
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ALH. High intensity focused ultrasound (HIFU) ablation of benign thyroid nodules - a systematic review. Journal of Therapeutic Ultrasound. 2017; 5:11 [<a href="/pmc/articles/PMC5434558/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5434558</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28523127" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28523127</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>33.</dt><dd><div class="bk_ref" id="ch16.ref33">Lang
|
|
BHH, Wong
|
|
CKH, Ma
|
|
EPM. Single-session high intensity focussed ablation (HIFU) versus open cervical hemithyroidectomy for benign thyroid nodule: analysis on early efficacy, safety and voice quality. International Journal of Hyperthermia. 2017; 33(8):868–874 [<a href="https://pubmed.ncbi.nlm.nih.gov/28540785" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28540785</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>34.</dt><dd><div class="bk_ref" id="ch16.ref34">Lang
|
|
BHH, Wong
|
|
CKH, Ma
|
|
EPM, Woo
|
|
YC, Chiu
|
|
KWH. A propensity-matched analysis of clinical outcomes between open thyroid lobectomy and high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules. Surgery. 2019; 165(1):85–91 [<a href="https://pubmed.ncbi.nlm.nih.gov/30392858" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30392858</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>35.</dt><dd><div class="bk_ref" id="ch16.ref35">Larijani
|
|
B, Pajouhi
|
|
M, Bastanhagh
|
|
MH, Sadjadi
|
|
A, Aghakhani
|
|
S, Zare
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F
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et al
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Role of levothyroxine suppressive therapy for benign cold nodules of thyroid: A randomized, double-blind, placebo-controlled clinical trial. Therapy. 2005; 2(6):883–888</div></dd></dl><dl class="bkr_refwrap"><dt>36.</dt><dd><div class="bk_ref" id="ch16.ref36">Larijani
|
|
B, Pajouhi
|
|
M, Bastanhagh
|
|
MH, Sadjadi
|
|
A, Sedighi
|
|
N, Eshraghian
|
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MR. Evaluation of suppressive therapy for cold thyroid nodules with levothyroxine: double-blind placebo-controlled clinical trial. Endocrine Practice. 1999; 5(5):251–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/15251662" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15251662</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>37.</dt><dd><div class="bk_ref" id="ch16.ref37">National Institute for Health and Care Excellence. Developing NICE guidelines: the manual [updated October 2018]. London. National Institute for Health and Care Excellence, 2014. Available from: <a href="http://www.nice.org.uk/article/PMG20/chapter/1%20Introduction%20and%20overview" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.nice.org.uk<wbr style="display:inline-block"></wbr>​/article/PMG20/chapter<wbr style="display:inline-block"></wbr>​/1%20Introduction%20and%20overview</a></div></dd></dl><dl class="bkr_refwrap"><dt>38.</dt><dd><div class="bk_ref" id="ch16.ref38">Pacella
|
|
CM, Mauri
|
|
G, Cesareo
|
|
R, Paqualini
|
|
V, Cianni
|
|
R, De Feo
|
|
P
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et al
|
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A comparison of laser with radiofrequency ablation for the treatment of benign thyroid nodules: a propensity score matching analysis. International Journal of Hyperthermia. 2017; 33(8):911–919 [<a href="https://pubmed.ncbi.nlm.nih.gov/28605944" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28605944</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>39.</dt><dd><div class="bk_ref" id="ch16.ref39">Papini
|
|
E, Bacci
|
|
V, Panunzi
|
|
C, Pacella
|
|
CM, Fabbrini
|
|
R, Bizzarri
|
|
G
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et al
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A prospective randomized trial of levothyroxine suppressive therapy for solitary thyroid nodules. Clinical Endocrinology. 1993; 38(5):507–13 [<a href="https://pubmed.ncbi.nlm.nih.gov/8330445" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8330445</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>40.</dt><dd><div class="bk_ref" id="ch16.ref40">Papini
|
|
E, Guglielmi
|
|
R, Bizzarri
|
|
G, Graziano
|
|
F, Bianchini
|
|
A, Brufani
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C
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et al
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Treatment of benign cold thyroid nodules: a randomized clinical trial of percutaneous laser ablation versus levothyroxine therapy or follow-up. Thyroid. 2007; 17(3):229–35 [<a href="https://pubmed.ncbi.nlm.nih.gov/17381356" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17381356</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>41.</dt><dd><div class="bk_ref" id="ch16.ref41">Papini
|
|
E, Petrucci
|
|
L, Guglielmi
|
|
R, Panunzi
|
|
C, Rinaldi
|
|
R, Bacci
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V
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et al
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Long-term changes in nodular goiter: a 5-year prospective randomized trial of levothyroxine suppressive therapy for benign cold thyroid nodules. Journal of Clinical Endocrinology and Metabolism. 1998; 83(3):780–3 [<a href="https://pubmed.ncbi.nlm.nih.gov/9506726" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9506726</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>42.</dt><dd><div class="bk_ref" id="ch16.ref42">Reverter
|
|
JL, Lucas
|
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A, Salinas
|
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I, Audi
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L, Foz
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M, Sanmarti
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A. Suppressive therapy with levothyroxine for solitary thyroid nodules. Clinical Endocrinology. 1992; 36(1):25–8 [<a href="https://pubmed.ncbi.nlm.nih.gov/1559296" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1559296</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>43.</dt><dd><div class="bk_ref" id="ch16.ref43">Sdano
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MT, Falciglia
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M, Welge
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JA, Steward
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DL. Efficacy of thyroid hormone suppression for benign thyroid nodules: Meta-analysis of randomized trials. Otolaryngology - Head and Neck Surgery. 2005; 133(3):391–396 [<a href="https://pubmed.ncbi.nlm.nih.gov/16143188" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16143188</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>44.</dt><dd><div class="bk_ref" id="ch16.ref44">Sewefy
|
|
AM, Tohamy
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TA, Esmael
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TM, Atyia
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AM. Intra-capsular total thyroid enucleation versus total thyroidectomy in treatment of benign multinodular goiter. A prospective randomized controlled clinical trial. International Journal of Surgery. 2017; 45:29–34 [<a href="https://pubmed.ncbi.nlm.nih.gov/28728986" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28728986</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>45.</dt><dd><div class="bk_ref" id="ch16.ref45">Sung
|
|
JY, Baek
|
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JH, Kim
|
|
KS, Lee
|
|
D, Yoo
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H, Kim
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JK
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et al
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Single-session treatment of benign cystic thyroid nodules with ethanol versus radiofrequency ablation: a prospective randomized study. Radiology. 2013; 269(1):293–300 [<a href="https://pubmed.ncbi.nlm.nih.gov/23616630" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23616630</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>46.</dt><dd><div class="bk_ref" id="ch16.ref46">Verde
|
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G, Papini
|
|
E, Pacella
|
|
CM, Gallotti
|
|
C, Delpiano
|
|
S, Strada
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S
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et al
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Ultrasound guided percutaneous ethanol injection in the treatment of cystic thyroid nodules. Clinical Endocrinology. 1994; 41(6):719–24 [<a href="https://pubmed.ncbi.nlm.nih.gov/7889606" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7889606</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>47.</dt><dd><div class="bk_ref" id="ch16.ref47">Wang
|
|
JF, Wu
|
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T, Hu
|
|
KP, Xu
|
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W, Zheng
|
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BW, Tong
|
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G
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et al
|
|
Complications following radiofrequency ablation of benign thyroid nodules: A systematic review. Chinese Medical Journal. 2017; 130(11):1361–1370 [<a href="/pmc/articles/PMC5455047/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5455047</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28524837" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28524837</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>48.</dt><dd><div class="bk_ref" id="ch16.ref48">Wemeau
|
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JL, Caron
|
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P, Schvartz
|
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C, Schlienger
|
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JL, Orgiazzi
|
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J, Cousty
|
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C
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et al
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Effects of thyroid-stimulating hormone suppression with levothyroxine in reducing the volume of solitary thyroid nodules and improving extranodular nonpalpable changes: a randomized, double-blind, placebo-controlled trial by the French Thyroid Research Group. Journal of Clinical Endocrinology and Metabolism. 2002; 87(11):4928–34 [<a href="https://pubmed.ncbi.nlm.nih.gov/12414852" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12414852</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>49.</dt><dd><div class="bk_ref" id="ch16.ref49">Yan
|
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J, Qiu
|
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T, Lu
|
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J, Wu
|
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Y, Yang
|
|
Y. Microwave ablation induces a lower systemic stress response in patients than open surgery for treatment of benign thyroid nodules. International Journal of Hyperthermia. 2018; 34(5):606–610 [<a href="https://pubmed.ncbi.nlm.nih.gov/29366346" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29366346</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>50.</dt><dd><div class="bk_ref" id="ch16.ref50">Yue
|
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WW, Li
|
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XL, Xu
|
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HX, Lu
|
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F, Sun
|
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LP, Guo
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LH
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et al
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Quality of life and cost-effectiveness of radiofrequency ablation versus open surgery for benign thyroid nodules: A retrospective cohort study. Scientific Reports. 2016; 6:37838 [<a href="/pmc/articles/PMC5121639/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5121639</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27883069" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27883069</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>51.</dt><dd><div class="bk_ref" id="ch16.ref51">Yue
|
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WW, Wang
|
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SR, Lu
|
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F, Li
|
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XL, Xu
|
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HX, Sun
|
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LP
|
|
et al
|
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Corrigendum: Quality of life and cost-effectiveness of radiofrequency ablation versus open surgery for benign thyroid nodules: A retrospective cohort study. Scientific Reports. 2017; 7:41342 [<a href="/pmc/articles/PMC5301244/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5301244</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28186108" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28186108</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>52.</dt><dd><div class="bk_ref" id="ch16.ref52">Yue
|
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WW, Wang
|
|
SR, Lu
|
|
F, Sun
|
|
LP, Guo
|
|
LH, Zhang
|
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YL
|
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et al
|
|
Radiofrequency ablation vs. microwave ablation for patients with benign thyroid nodules: a propensity score matching study. Endocrine. 2017; 55(2):485–495 [<a href="https://pubmed.ncbi.nlm.nih.gov/27905049" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27905049</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>53.</dt><dd><div class="bk_ref" id="ch16.ref53">Zelmanovitz
|
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F, Genro
|
|
S, Gross
|
|
JL. Suppressive therapy with levothyroxine for solitary thyroid nodules: a double-blind controlled clinical study and cumulative meta-analyses. Journal of Clinical Endocrinology and Metabolism. 1998; 83(11):3881–5 [<a href="https://pubmed.ncbi.nlm.nih.gov/9814462" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9814462</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>54.</dt><dd><div class="bk_ref" id="ch16.ref54">Zhi
|
|
X, Zhao
|
|
N, Liu
|
|
Y, Liu
|
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JB, Teng
|
|
C, Qian
|
|
L. Microwave ablation compared to thyroidectomy to treat benign thyroid nodules. International Journal of Hyperthermia. 2018; 34(5):644–652 [<a href="https://pubmed.ncbi.nlm.nih.gov/29577796" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29577796</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>55.</dt><dd><div class="bk_ref" id="ch16.ref55">Zingrillo
|
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M, Modoni
|
|
S, Conte
|
|
M, Frusciante
|
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V, Trischitta
|
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V. Percutaneous ethanol injection plus radioiodine versus radioiodine alone in the treatment of large toxic thyroid nodules. Journal of Nuclear Medicine. 2003; 44(2):207–10 [<a href="https://pubmed.ncbi.nlm.nih.gov/12571210" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12571210</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>56.</dt><dd><div class="bk_ref" id="ch16.ref56">Zingrillo
|
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M, Torlontano
|
|
M, Ghiggi
|
|
MR, Frusciante
|
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V, Varraso
|
|
A, Liuzzi
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A
|
|
et al
|
|
Radioiodine and percutaneous ethanol injection in the treatment of large toxic thyroid nodule: a long-term study. Thyroid. 2000; 10(11):985–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/11128727" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11128727</span></a>]</div></dd></dl></dl></div><div id="appendixesappgroup16"><h2 id="_appendixesappgroup16_">Appendices</h2><div id="ch16.appa"><h3>Appendix A. Review protocols</h3><p id="ch16.appa.tab1"><a href="/books/NBK577222/table/ch16.appa.tab1/?report=objectonly" target="object" rid-ob="figobch16appatab1" class="figpopup">Table 14. Table</a></p><p id="ch16.appa.tab2"><a href="/books/NBK577222/table/ch16.appa.tab2/?report=objectonly" target="object" rid-ob="figobch16appatab2" class="figpopup">Table 15. Health economic review protocol</a></p></div><div id="ch16.appb"><h3>Appendix B. Literature search strategies</h3><p>The literature searches for this review are detailed below and complied with the methodology outlined in Developing NICE guidelines: the manual 2014, updated 2018 <a href="https://www.nice.org.uk/guidance/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.nice.org.uk/guidance/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869</a></p><p><i>For more detailed information, please see the Methodology Review</i>.</p><div id="ch16.appb.s1"><h4>B.1. Clinical search literature search strategy</h4><p>Searches were constructed using a PICO framework where population (P) terms were combined with Intervention (I) and in some cases Comparison (C) terms. Outcomes (O) are rarely used in search strategies for interventions as these concepts may not be well described in title, abstract or indexes and therefore difficult to retrieve. Search filters were applied to the search where appropriate.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch16appbtab1"><a href="/books/NBK577222/table/ch16.appb.tab1/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch16appbtab1" rid-ob="figobch16appbtab1"><img class="small-thumb" src="/books/NBK577222/table/ch16.appb.tab1/?report=thumb" src-large="/books/NBK577222/table/ch16.appb.tab1/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch16.appb.tab1"><a href="/books/NBK577222/table/ch16.appb.tab1/?report=objectonly" target="object" rid-ob="figobch16appbtab1">Table</a></h4><p class="float-caption no_bottom_margin">Exclusions Randomised controlled trials</p></div></div><p id="ch16.appb.tab2"><a href="/books/NBK577222/table/ch16.appb.tab2/?report=objectonly" target="object" rid-ob="figobch16appbtab2" class="figpopup">Medline (Ovid) search terms</a></p><p id="ch16.appb.tab3"><a href="/books/NBK577222/table/ch16.appb.tab3/?report=objectonly" target="object" rid-ob="figobch16appbtab3" class="figpopup">Embase (Ovid) search terms</a></p><p id="ch16.appb.tab4"><a href="/books/NBK577222/table/ch16.appb.tab4/?report=objectonly" target="object" rid-ob="figobch16appbtab4" class="figpopup">Cochrane Library (Wiley) search terms</a></p></div><div id="ch16.appb.s2"><h4>B.2. Health Economics literature search strategy</h4><p>Health economic evidence was identified by conducting a broad search relating to a thyroid disease population in NHS Economic Evaluation Database (NHS EED – this ceased to be updated after March 2015) and the Health Technology Assessment database (HTA) with no date restrictions. NHS EED and HTA databases are hosted by the Centre for Research and Dissemination (CRD). Additional searches were run on Medline and Embase for health economics, economic modelling and quality of life studies.</p><p id="ch16.appb.tab5"><a href="/books/NBK577222/table/ch16.appb.tab5/?report=objectonly" target="object" rid-ob="figobch16appbtab5" class="figpopup">Table 16. Database date parameters and filters used</a></p><p id="ch16.appb.tab6"><a href="/books/NBK577222/table/ch16.appb.tab6/?report=objectonly" target="object" rid-ob="figobch16appbtab6" class="figpopup">Medline (Ovid) search terms</a></p><p id="ch16.appb.tab7"><a href="/books/NBK577222/table/ch16.appb.tab7/?report=objectonly" target="object" rid-ob="figobch16appbtab7" class="figpopup">Embase (Ovid) search terms</a></p><p id="ch16.appb.tab8"><a href="/books/NBK577222/table/ch16.appb.tab8/?report=objectonly" target="object" rid-ob="figobch16appbtab8" class="figpopup">NHS EED and HTA (CRD) search terms</a></p></div></div><div id="ch16.appc"><h3>Appendix C. Clinical evidence selection</h3><p id="ch16.appc.fig1"><a href="/books/NBK577222/figure/ch16.appc.fig1/?report=objectonly" target="object" rid-ob="figobch16appcfig1" class="figpopup">Figure 1. Flow chart of clinical study selection for the review of benign thyroid enlargement</a></p></div><div id="ch16.appd"><h3>Appendix D. Clinical evidence tables</h3><p id="ch16.appd.et1"><a href="/books/NBK577222/bin/ch16-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (484K)</span></p></div><div id="ch16.appe"><h3>Appendix E. Forest plots</h3><div id="ch16.appe.s1"><h4>E.1. Non-cystic nodules – T4 vs placebo/follow-up only</h4><p id="ch16.appe.fig1"><a href="/books/NBK577222/figure/ch16.appe.fig1/?report=objectonly" target="object" rid-ob="figobch16appefig1" class="figpopup">Figure 2. Nodulevolume (ml, 6-60 months)</a></p><p id="ch16.appe.fig2"><a href="/books/NBK577222/figure/ch16.appe.fig2/?report=objectonly" target="object" rid-ob="figobch16appefig2" class="figpopup">Figure 3. Nodule volume (% reduction, 12 months)</a></p><p id="ch16.appe.fig3"><a href="/books/NBK577222/figure/ch16.appe.fig3/?report=objectonly" target="object" rid-ob="figobch16appefig3" class="figpopup">Figure 4. Thyroid volume (ml, 12 months)</a></p><p id="ch16.appe.fig4"><a href="/books/NBK577222/figure/ch16.appe.fig4/?report=objectonly" target="object" rid-ob="figobch16appefig4" class="figpopup">Figure 5. Hyperthyroidism (18 months)</a></p><p id="ch16.appe.fig5"><a href="/books/NBK577222/figure/ch16.appe.fig5/?report=objectonly" target="object" rid-ob="figobch16appefig5" class="figpopup">Figure 6. Improvement in symptoms (12 months)</a></p><p id="ch16.appe.fig6"><a href="/books/NBK577222/figure/ch16.appe.fig6/?report=objectonly" target="object" rid-ob="figobch16appefig6" class="figpopup">Figure 7. Arrhythmias (AF, 12 months)</a></p></div><div id="ch16.appe.s2"><h4>E.2. Non-cystic nodules – RFA vs follow-up</h4><p id="ch16.appe.fig7"><a href="/books/NBK577222/figure/ch16.appe.fig7/?report=objectonly" target="object" rid-ob="figobch16appefig7" class="figpopup">Figure 8. Nodule volume (ml, 6 months)</a></p><p id="ch16.appe.fig8"><a href="/books/NBK577222/figure/ch16.appe.fig8/?report=objectonly" target="object" rid-ob="figobch16appefig8" class="figpopup">Figure 9. Hypothyroidism (6 months)</a></p><p id="ch16.appe.fig9"><a href="/books/NBK577222/figure/ch16.appe.fig9/?report=objectonly" target="object" rid-ob="figobch16appefig9" class="figpopup">Figure 10. Hyperthyroidism (6 months)</a></p><p id="ch16.appe.fig10"><a href="/books/NBK577222/figure/ch16.appe.fig10/?report=objectonly" target="object" rid-ob="figobch16appefig10" class="figpopup">Figure 11. Compressive symptoms (6 months, 0-10, VAS, higher is worse)</a></p></div><div id="ch16.appe.s3"><h4>E.3. Non-cystic nodules – LA vs FU</h4><p id="ch16.appe.fig11"><a href="/books/NBK577222/figure/ch16.appe.fig11/?report=objectonly" target="object" rid-ob="figobch16appefig11" class="figpopup">Figure 12. Change in nodule volume (ml, 12 months)</a></p><p id="ch16.appe.fig12"><a href="/books/NBK577222/figure/ch16.appe.fig12/?report=objectonly" target="object" rid-ob="figobch16appefig12" class="figpopup">Figure 13. Improvement in symptoms (12 months)</a></p></div><div id="ch16.appe.s4"><h4>E.4. Non-cystic nodules – LA vs T4</h4><p id="ch16.appe.fig13"><a href="/books/NBK577222/figure/ch16.appe.fig13/?report=objectonly" target="object" rid-ob="figobch16appefig13" class="figpopup">Figure 14. Change in nodule volume (ml, 12 months)</a></p><p id="ch16.appe.fig14"><a href="/books/NBK577222/figure/ch16.appe.fig14/?report=objectonly" target="object" rid-ob="figobch16appefig14" class="figpopup">Figure 15. Improvement in symptoms (12 months)</a></p></div><div id="ch16.appe.s5"><h4>E.5. Non-cystic nodules – PEI vs T4</h4><p id="ch16.appe.fig15"><a href="/books/NBK577222/figure/ch16.appe.fig15/?report=objectonly" target="object" rid-ob="figobch16appefig15" class="figpopup">Figure 16. Reduction in nodule volume (%, 12 months)</a></p><p id="ch16.appe.fig16"><a href="/books/NBK577222/figure/ch16.appe.fig16/?report=objectonly" target="object" rid-ob="figobch16appefig16" class="figpopup">Figure 17. Compressive symptoms (any improvement, 12 months)</a></p><p id="ch16.appe.fig17"><a href="/books/NBK577222/figure/ch16.appe.fig17/?report=objectonly" target="object" rid-ob="figobch16appefig17" class="figpopup">Figure 18. Pain (on procedure, 12 months)</a></p><p id="ch16.appe.fig18"><a href="/books/NBK577222/figure/ch16.appe.fig18/?report=objectonly" target="object" rid-ob="figobch16appefig18" class="figpopup">Figure 19. Hyperthyroidism (symptoms, 12 months)</a></p></div><div id="ch16.appe.s6"><h4>E.6. Non-cystic nodules – HIFU vs surgery</h4><p id="ch16.appe.fig19"><a href="/books/NBK577222/figure/ch16.appe.fig19/?report=objectonly" target="object" rid-ob="figobch16appefig19" class="figpopup">Figure 20. Hypothyroidism (6 months)</a></p><p id="ch16.appe.fig20"><a href="/books/NBK577222/figure/ch16.appe.fig20/?report=objectonly" target="object" rid-ob="figobch16appefig20" class="figpopup">Figure 21. RLN damage (temporary, 6 months)</a></p><p id="ch16.appe.fig21"><a href="/books/NBK577222/figure/ch16.appe.fig21/?report=objectonly" target="object" rid-ob="figobch16appefig21" class="figpopup">Figure 22. Bleeding (6 months)</a></p><p id="ch16.appe.fig22"><a href="/books/NBK577222/figure/ch16.appe.fig22/?report=objectonly" target="object" rid-ob="figobch16appefig22" class="figpopup">Figure 23. Infection (6 months)</a></p><p id="ch16.appe.fig23"><a href="/books/NBK577222/figure/ch16.appe.fig23/?report=objectonly" target="object" rid-ob="figobch16appefig23" class="figpopup">Figure 24. Improvement in symptoms (any (slight/moderate/severe), 6 months)</a></p></div><div id="ch16.appe.s7"><h4>E.7. Cystic nodules – RFA vs PEI</h4><p id="ch16.appe.fig24"><a href="/books/NBK577222/figure/ch16.appe.fig24/?report=objectonly" target="object" rid-ob="figobch16appefig24" class="figpopup">Figure 25. Nodule volume (% reduction, 6 months)</a></p><p id="ch16.appe.fig25"><a href="/books/NBK577222/figure/ch16.appe.fig25/?report=objectonly" target="object" rid-ob="figobch16appefig25" class="figpopup">Figure 26. Compressive symptoms (0-10, VAS, higher is worse, 6 months)</a></p><p id="ch16.appe.fig26"><a href="/books/NBK577222/figure/ch16.appe.fig26/?report=objectonly" target="object" rid-ob="figobch16appefig26" class="figpopup">Figure 27. Pain (mild or greater, during procedure)</a></p></div><div id="ch16.appe.s8"><h4>E.8. Non-specific nodules – RFA vs surgery</h4><p id="ch16.appe.fig27"><a href="/books/NBK577222/figure/ch16.appe.fig27/?report=objectonly" target="object" rid-ob="figobch16appefig27" class="figpopup">Figure 28. Quality of life (SF-36, general health, 0-100, higher is better)</a></p><p id="ch16.appe.fig28"><a href="/books/NBK577222/figure/ch16.appe.fig28/?report=objectonly" target="object" rid-ob="figobch16appefig28" class="figpopup">Figure 29. Quality of life (SF-36, vitality, 0-100, higher is better)</a></p><p id="ch16.appe.fig29"><a href="/books/NBK577222/figure/ch16.appe.fig29/?report=objectonly" target="object" rid-ob="figobch16appefig29" class="figpopup">Figure 30. Quality of life (SF-36, mental health, 0-100, higher is better)</a></p></div><div id="ch16.appe.s9"><h4>E.9. Non-specific nodules – Microwave ablation vs surgery</h4><p id="ch16.appe.fig30"><a href="/books/NBK577222/figure/ch16.appe.fig30/?report=objectonly" target="object" rid-ob="figobch16appefig30" class="figpopup">Figure 31. Hoarseness (temporary, 12 months)</a></p><p id="ch16.appe.fig31"><a href="/books/NBK577222/figure/ch16.appe.fig31/?report=objectonly" target="object" rid-ob="figobch16appefig31" class="figpopup">Figure 32. Post-operative pain (temporary, 12 months)</a></p><p id="ch16.appe.fig32"><a href="/books/NBK577222/figure/ch16.appe.fig32/?report=objectonly" target="object" rid-ob="figobch16appefig32" class="figpopup">Figure 33. Resolution of compressive symptoms (12 months)</a></p></div></div><div id="ch16.appf"><h3>Appendix F. GRADE tables</h3><p id="ch16.appf.tab1"><a href="/books/NBK577222/table/ch16.appf.tab1/?report=objectonly" target="object" rid-ob="figobch16appftab1" class="figpopup">Table 17. Clinical evidence profile: T4 vs PBO/FU</a></p><p id="ch16.appf.tab2"><a href="/books/NBK577222/table/ch16.appf.tab2/?report=objectonly" target="object" rid-ob="figobch16appftab2" class="figpopup">Table 18. Clinical evidence profile: RFA vs FU</a></p><p id="ch16.appf.tab3"><a href="/books/NBK577222/table/ch16.appf.tab3/?report=objectonly" target="object" rid-ob="figobch16appftab3" class="figpopup">Table 19. Clinical evidence profile: LA vs FU</a></p><p id="ch16.appf.tab4"><a href="/books/NBK577222/table/ch16.appf.tab4/?report=objectonly" target="object" rid-ob="figobch16appftab4" class="figpopup">Table 20. Clinical evidence profile: LA vs T4</a></p><p id="ch16.appf.tab5"><a href="/books/NBK577222/table/ch16.appf.tab5/?report=objectonly" target="object" rid-ob="figobch16appftab5" class="figpopup">Table 21. Clinical evidence profile: PEI vs T4</a></p><p id="ch16.appf.tab6"><a href="/books/NBK577222/table/ch16.appf.tab6/?report=objectonly" target="object" rid-ob="figobch16appftab6" class="figpopup">Table 22. Clinical evidence profile: HIFU vs surgery</a></p><p id="ch16.appf.tab7"><a href="/books/NBK577222/table/ch16.appf.tab7/?report=objectonly" target="object" rid-ob="figobch16appftab7" class="figpopup">Table 23. Clinical evidence profile: RFA vs PEI</a></p><p id="ch16.appf.tab8"><a href="/books/NBK577222/table/ch16.appf.tab8/?report=objectonly" target="object" rid-ob="figobch16appftab8" class="figpopup">Table 24. Clinical evidence profile: RFA vs Surgery</a></p><p id="ch16.appf.tab9"><a href="/books/NBK577222/table/ch16.appf.tab9/?report=objectonly" target="object" rid-ob="figobch16appftab9" class="figpopup">Table 25. Clinical evidence profile: Microwave ablation vs Surgery</a></p></div><div id="ch16.appg"><h3>Appendix G. Health economic evidence selection</h3><p id="ch16.appg.fig1"><a href="/books/NBK577222/figure/ch16.appg.fig1/?report=objectonly" target="object" rid-ob="figobch16appgfig1" class="figpopup">Figure 34. Flow chart of health economic study selection for the guideline</a></p></div><div id="ch16.apph"><h3>Appendix H. Health economic evidence tables</h3><p>None</p></div><div id="ch16.appi"><h3>Appendix I. Health economic analysis</h3><p>None</p></div><div id="ch16.appj"><h3>Appendix J. Excluded studies</h3><div id="ch16.appj.s1"><h4>J.1. Excluded clinical studies</h4><p id="ch16.appj.tab1"><a href="/books/NBK577222/table/ch16.appj.tab1/?report=objectonly" target="object" rid-ob="figobch16appjtab1" class="figpopup">Table 26. Studies excluded from the clinical review</a></p></div><div id="ch16.appj.s2"><h4>J.2. Excluded health economic studies</h4><p>None</p></div></div><div id="ch16.appk"><h3>Appendix K. Research recommendations</h3><div id="ch16.appk.s1"><h4>K1 Research question: What is the clinical and cost effectiveness of percutaneous thermal ablation for benign thyroid nodules?</h4><div id="ch16.appk.s1.1"><h5>Why this is important</h5><p>Percutaneous interventional ablation is effective in the management of malignant solid organ disease where the cancer can be destroyed through the application of thermal destructive techniques but there is growing evidence in the literature in application of these to benign thyroid disease.</p><p>Benign thyroid nodules and enlargement is common with reported prevalence rates increasing concomitant with increased imaging – many cases being identified incidentally. The majority of cases do not require intervention; however, a subset of patients develop symptoms, usually relating to mass effect or cosmetic embarrassment, requiring volume reduction of the affected gland or portion thereof. This usually requires surgical intervention. Cysts may be aspirated or ablated with ethanol but solid (or predominantly solid) nodules require more invasive treatment – either surgery or percutaneous ablation.</p><p>Percutaneous thermal ablation treatments and particularly cryotherapy, microwave ablation and high intensity focused ultrasound are not widely available in the UK and there is currently very little evidence regarding their effectiveness in the management of benign thyroid nodules. Further research on the clinical and cost-effectiveness of those treatments could provide a rationale for the expansion of their availability across the UK, providing less invasive management options than currently available with potential benefits for patients with thyroid enlargement.</p><p>If percutaneous thermal ablation offers comparative clinical outcomes to traditional open surgical techniques, there would be potential benefits to a less invasive management strategy to debulk disease and possible opportunities for cost effectiveness, both warranting further investigation.</p><p id="ch16.appk.tab1"><a href="/books/NBK577222/table/ch16.appk.tab1/?report=objectonly" target="object" rid-ob="figobch16appktab1" class="figpopup">Criteria for selecting high-priority research recommendations</a></p></div></div></div></div></div><div class="fm-sec"><div><p>FINAL</p></div><div><p>Intervention evidence review underpinning recommendations 1.9.7 to 1.9.12 in the guideline. See also evidence review F</p><p>Developed by the National Guideline Centre, hosted by the Royal College of Physicians</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and, where appropriate, their carer or guardian.</p><p>Local commissioners and providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div><div class="small"><span class="label">Bookshelf ID: NBK577222</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35129914" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">35129914</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobch16tab1"><div id="ch16.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO characteristics of review question</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_ch16.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch16.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People with non-malignant thyroid enlargement</td></tr><tr><th id="hd_b_ch16.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><td headers="hd_b_ch16.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Surgery</p>
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<p>Radiofrequency ablation</p>
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<p>High intensity focused ultrasound</p>
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<p>Ethanol ablation</p>
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<p>Radioactive iodine ablation</p>
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<p>Levothyroxine therapy</p>
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<p>Microwave ablation</p>
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<p>Laser ablation</p>
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<p>Monitoring only</p>
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<p>Placebo/sham</p>
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</td></tr><tr><th id="hd_b_ch16.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparisons</th><td headers="hd_b_ch16.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Any of the above vs any other</td></tr><tr><th id="hd_b_ch16.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_ch16.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p><b>Critical</b>
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<ul id="ch16.l1"><li id="ch16.lt1" class="half_rhythm"><div>Mortality (dichotomous, ≥1 year)</div></li><li id="ch16.lt2" class="half_rhythm"><div>Quality of life (continuous)</div></li></ul></p>
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<p><b>Important</b>
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<ul id="ch16.l2"><li id="ch16.lt3" class="half_rhythm"><div>Percent change in size of nodule/goitre (continuous)</div></li><li id="ch16.lt4" class="half_rhythm"><div>Malignancy (dichotomous)</div></li><li id="ch16.lt5" class="half_rhythm"><div>Hypothyroidism (dichotomous)</div></li><li id="ch16.lt6" class="half_rhythm"><div>Hyperthyroidism (dichotomous)</div></li><li id="ch16.lt7" class="half_rhythm"><div>Hypoparathyroidism (dichotomous)</div></li><li id="ch16.lt8" class="half_rhythm"><div>Recurrent laryngeal nerve damage (dichotomous)</div></li><li id="ch16.lt9" class="half_rhythm"><div>Bleeding (dichotomous)</div></li><li id="ch16.lt10" class="half_rhythm"><div>Infection (dichotomous)</div></li><li id="ch16.lt11" class="half_rhythm"><div>Arrhythmia (dichotomous)</div></li><li id="ch16.lt12" class="half_rhythm"><div>Osteoporosis (dichotomous)</div></li><li id="ch16.lt13" class="half_rhythm"><div>Pain (continuous)</div></li><li id="ch16.lt14" class="half_rhythm"><div>Compressive symptoms (continuous)</div></li><li id="ch16.lt15" class="half_rhythm"><div>Patient/family/carer experience (continuous)</div></li></ul></p></td></tr><tr><th id="hd_b_ch16.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_ch16.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCTs preferred, if no RCTs available (on an intervention by intervention basis) to consider non-randomised cohort studies in which key confounders (age, sex, co-existing conditions, size of nodule, type of nodule) are addressed, either through restriction or appropriate matching/statistical adjustment</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16tab2"><div id="ch16.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of studies included in the evidence review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention and comparison</th><th id="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Baek 2015<a class="bibr" href="#ch16.ref1" rid="ch16.ref1"><sup>1</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Radiofrequency ablation, n = 22, 1 dose, 40-80 W RF power, moving-shot technique</p>
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<p>Percutaneous ethanol injection, n = 24, 1 dose, 99% ethanol, volume ~50% of aspirated</p>
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</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Adults (mean age 51, SD 15)</p>
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<p>Euthyroid</p>
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<p>Nodule (predominantly cystic (all 50-90% cystic component), cosmetic/compres sive symptoms)</p>
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<p>South Korea</p>
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</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Nodule volume</p>
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<p>Compressive symptoms</p>
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<p>6 month follow-up</p>
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</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bennedbaek 1998<a class="bibr" href="#ch16.ref5" rid="ch16.ref5"><sup>5</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Percutaneous ethanol injection, n = 25, 1 dose, 98% ethanol, volume 20-50% of pre-treatment nodule volume</p>
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<p>Levothyroxine, n = 25, 1.5 μg/kg, titrated to TSH 0.1-0.4 (mU/L) after 1 month</p>
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</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Adults (mean age 44, range 37-52)</p>
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<p>Euthyroid</p>
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<p>Nodule (benign on FNAB, cold, causing discomfort, solid)</p>
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<p>Denmark</p>
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</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Nodule volume</p>
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<p>Compressive symptoms</p>
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<p>Pain</p>
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<p>Hyperthyroidism</p>
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<p>12 month follow-up</p>
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</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cesareo 2010<a class="bibr" href="#ch16.ref7" rid="ch16.ref7"><sup>7</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Levothyroxine, n = 36, 2 μg/kg body weight</p>
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<p>Follow-up only, n = 35</p>
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</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Adults (mean age 36, SD 10)</p>
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<p>Euthyroid</p>
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<p>Multinodule (colloid, hypofunctioning)</p>
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<p>Italy</p>
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</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Nodule volume</p>
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<p>Thyroid volume</p>
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<p>12 month follow-up</p>
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</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Area of iodine deficiency</td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cesareo 2015<a class="bibr" href="#ch16.ref8" rid="ch16.ref8"><sup>8</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Radiofrequency ablation, n = 42, 1 dose, 60 W RF power, moving-shot technique</p>
|
|
<p>Follow-up only, n = 42</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 55, SD 13)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodule (solid, cosmetic/compres sive symptoms or volume >5ml/diameter >2cm + growing)</p>
|
|
<p>Italy</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>Hypothyroidism</p>
|
|
<p>Hyperthyroidism</p>
|
|
<p>Compressive symptoms</p>
|
|
<p>6 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Deandrea 2015<a class="bibr" href="#ch16.ref13" rid="ch16.ref13"><sup>13</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Radiofrequency ablation, n = 40, 1 dose, moving-shot technique</p>
|
|
<p>Follow-up only, n = 40</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 52, SD 12)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodule (solid, benign as confirmed by FNAB, volume 10-20ml, pressure or cosmetic symptoms)</p>
|
|
<p>Italy, South Korea</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>Compressive symptoms</p>
|
|
<p>6 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gharib 1987<a class="bibr" href="#ch16.ref21" rid="ch16.ref21"><sup>21</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 28, daily dose of 3 μg/kg body weight</p>
|
|
<p>Placebo, n = 25</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age ~45, SD 16)</p>
|
|
<p>Nodule (benign as confirmed by FNAB, 43% solid)</p>
|
|
<p>USA</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>6 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Grussendorf 2011<a class="bibr" href="#ch16.ref24" rid="ch16.ref24"><sup>24</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 206, initial 75 μg/d, titrated to a TSH between 0.2 and 0.8 from 3 months</p>
|
|
<p>Placebo, n = 199</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 47, range 44.6-48.5)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodule (at least 1 cm in diameter, ≤20% cystic component, non-malignant according to guidelines)</p>
|
|
<p>Germany</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>Arrhythmias</p>
|
|
<p>12 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">‘Majority’ of participants achieved TSH suppression, exact proportion not stated</td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lang 2018<a class="bibr" href="#ch16.ref34" rid="ch16.ref34"><sup>34</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>High intensity focused ultrasound, n = 77</p>
|
|
<p>Surgery, open lobectomy, n = 77</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 50, SD 14)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodule (index nodule causing symptoms, 10-50mm, predominantly solid)</p>
|
|
<p>China</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>Hypothyroidism</p>
|
|
<p>RLN damage</p>
|
|
<p>Bleeding</p>
|
|
<p>Infection</p>
|
|
<p>6 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-randomised study, propensity score matched for age, sex, BMI, TSH, size of nodule, volume of nodule</td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Larijani 1999<a class="bibr" href="#ch16.ref36" rid="ch16.ref36"><sup>36</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 32, daily dose of 1.5 to 2.0 μg/kg body weight</p>
|
|
<p>Placebo, n = 30</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 32.9, SD 10.8)</p>
|
|
<p>Nodule (40% of nodules were solid, benign as confirmed by FNAB, mean starting volume 13ml)</p>
|
|
<p>Iran</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>12 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Larijani 2005<a class="bibr" href="#ch16.ref35" rid="ch16.ref35"><sup>35</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 31, 1.5-2 μg/kg, aimed at complete TSH suppression (<0.1 μIU/ml)</p>
|
|
<p>Placebo, n = 27</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 36, SD 10)</p>
|
|
<p>Nodule (benign as confirmed by FNAB)</p>
|
|
<p>Iran</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>24 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ozkaya 2010<a class="bibr" href="#ch16.ref6" rid="ch16.ref6"><sup>6</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 35, 50-100mg/day</p>
|
|
<p>Follow-up only, n = 27</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age not stated)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodule (benign by FNAB, <2cm, non-cystic)</p>
|
|
<p>Turkey</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>12 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Papini 1993<a class="bibr" href="#ch16.ref39" rid="ch16.ref39"><sup>39</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 54, daily dose of 2.0 ug/kg initially, then titrated to TSH suppression</p>
|
|
<p>Placebo, n = 56</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 43, SD 11)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodule (colloid, volume >1ml, solid, hypofunctioning/n ormal)</p>
|
|
<p>Italy</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>12 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TSH suppression achieved in 88% of levothyroxine group</td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Papini 1998<a class="bibr" href="#ch16.ref41" rid="ch16.ref41"><sup>41</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 42, daily dose of 2.0 μg/kg</p>
|
|
<p>Follow-up only, n = 41</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 42, SD 13)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodule (colloid, greatest diameter 10-30mm, hypofunctioning)</p>
|
|
<p>Italy</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>5 year follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TSH suppression achieved in 48% of levothyroxine group</td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Papini 2007<a class="bibr" href="#ch16.ref40" rid="ch16.ref40"><sup>40</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 21, daily dose of 1.5 μg/kg, titrated at 1 month to TSH <0.3 μIU/ml</p>
|
|
<p>Laser ablation, n = 21, 1 session for all participants, US guided, 1-4 illuminations, mean 1200J/ml of thyroid tissue</p>
|
|
<p>Follow-up only, n = 20</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 47, SD 7)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodule (non-cystic, >5ml, hypofunctioning, benign per FNAB)</p>
|
|
<p>Italy</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>Compressive symptoms</p>
|
|
<p>12 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reverter 1992<a class="bibr" href="#ch16.ref42" rid="ch16.ref42"><sup>42</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 20, daily dose of 100 μg/d for 2 weeks, then 200 μg/d and titrated to TSH <0.1 mIU/ml</p>
|
|
<p>Follow-up only, n = 20</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 40, SD 10)</p>
|
|
<p>Nodule (majority solid or mixed, hypofunctoining, benign per FNAB)</p>
|
|
<p>Spain</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>12 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">TSH suppression achieved in 100% of levothyroxine group</td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sung 2013<a class="bibr" href="#ch16.ref45" rid="ch16.ref45"><sup>45</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Radiofrequency ablation, n = 25, 1 dose, 50-70 W RF power, moving-shot technique</p>
|
|
<p>Percutaneous ethanol injection, n = 25, 1 dose, 99% ethanol, volume ~50% of aspirated</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 42, SD 10)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodule (cystic (cystic portion >90%), cosmetic/compres sion symptoms, benign by FNAB)</p>
|
|
<p>South Korea</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>Compressive symptoms</p>
|
|
<p>Pain</p>
|
|
<p>6 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wemeau 2002<a class="bibr" href="#ch16.ref48" rid="ch16.ref48"><sup>48</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 64, daily dose of 2.5 to 2.0 μg/kg body weight, titrated to TSH <0.3μIU/ml after 4 weeks</p>
|
|
<p>Placebo, n = 59</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age ~39, SD 9)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodules (benign as confirmed by FNAB, non-cystic cold nodules only)</p>
|
|
<p>France</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>Hyperthyroidism</p>
|
|
<p>18 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Yue 2016<a class="bibr" href="#ch16.ref50" rid="ch16.ref50"><sup>50</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Radiofrequency ablation, n = 108, moving shot technique</p>
|
|
<p>Surgery, n = 108, hemithyroidectomy</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 51, SD 13)</p>
|
|
<p>Euthyroid</p>
|
|
<p>Nodules (symptoms or anxiety over malignancy)</p>
|
|
<p>China</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life</p>
|
|
<p>6 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Non-randomised study</p>
|
|
<p>Surgical cohort included some people with uncertain malignancy status</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zelmanovitz 1998<a class="bibr" href="#ch16.ref53" rid="ch16.ref53"><sup>53</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Levothyroxine, n = 24, initial 2.5-3.0 μg/kg, adjusted after 4 weeks to TSH <0.3 μIU/ml</p>
|
|
<p>Placebo, n = 27</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 43, SD 12)</p>
|
|
<p>Nodules (hypofunctioning, non-cystic)</p>
|
|
<p>Brazil</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>12 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Suppression maintained in 86% of participants</td></tr><tr><td headers="hd_h_ch16.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zhi 2018<a class="bibr" href="#ch16.ref54" rid="ch16.ref54"><sup>54</sup></a></td><td headers="hd_h_ch16.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Microwave ablation, n = 30, excluded those (n = 2) with treatment failure (VRR <50% at 6 months)</p>
|
|
<p>Surgery, n = 30 hemithyroidectomy for those without a >1cm contralateral nodule (n = 24), those needing total excluded</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Adults (mean age 53, SD 10)</p>
|
|
<p>Nodules (mix of solid and cystic, >2cm in at least one dimension, causing symptoms or rapidly growing)</p>
|
|
<p>China</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>Hoarseness</p>
|
|
<p>Pain</p>
|
|
<p>Symptoms</p>
|
|
<p>12 month follow-up</p>
|
|
</td><td headers="hd_h_ch16.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16tab3"><div id="ch16.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Clinical evidence summary: Levothyroxine vs placebo/follow-up only, non-cystic nodules</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab3_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch16.tab3_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch16.tab3_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch16.tab3_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch16.tab3_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch16.tab3_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch16.tab3_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.tab3_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95 % CI)</th><th id="hd_h_ch16.tab3_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch16.tab3_1_1_1_5" id="hd_h_ch16.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with placebo or follow-up only</th><th headers="hd_h_ch16.tab3_1_1_1_5" id="hd_h_ch16.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with T4 (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>ml</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>735</p>
|
|
<p>(11 studies)</p>
|
|
<p>6-60 months</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>1</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean nodule volume in the control groups was</p>
|
|
<p>2.5 ml</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean nodule volume in the intervention groups was</p>
|
|
<p>0.79 lower</p>
|
|
<p>(1.13 to 0.45 lower)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Reduction in nodule volume</p>
|
|
<p>%</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>405</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊕</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean reduction in nodule volume in the control groups was</p>
|
|
<p>5.2 %</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean reduction in nodule volume in the intervention groups was</p>
|
|
<p>6.9% higher</p>
|
|
<p>(0.91 lower to 14.71 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Thyroid volume</p>
|
|
<p>ml</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>71</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>2</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean thyroid volume in the control groups was</p>
|
|
<p>20 ml</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean thyroid volume in the intervention groups was</p>
|
|
<p>9.4 lower</p>
|
|
<p>(14.53 to 4.27 lower)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hyperthyroidism ‘Severe’ (nil else specified)</td><td headers="hd_h_ch16.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>123</p>
|
|
<p>(1 study)</p>
|
|
<p>18 months</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.92 (0.06 to 14.41)</td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17 per 1000</td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 fewer per 1000</p>
|
|
<p>(from 16 fewer to 228 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Improvement in symptoms</td><td headers="hd_h_ch16.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>29</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 7.43 (0.44 to 125.12)</td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1000</td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>130 more per 1000</p>
|
|
<p>(from 70 fewer to 330 more)<sup>3</sup></p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Arrhythmias Reported as AF</td><td headers="hd_h_ch16.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>405</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 0.13 (0.01 to 2.09)</td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 per 1000</td><td headers="hd_h_ch16.tab3_1_1_1_5 hd_h_ch16.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>9 fewer per 1000</p>
|
|
<p>(from 10 fewer to 11 more)</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.tab3_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.tab3_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.tab3_3"><p class="no_margin">Zero events in control arm</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16tab4"><div id="ch16.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Clinical evidence summary: Radiofrequency ablation vs follow-up only, non-cystic nodules</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab4_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch16.tab4_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch16.tab4_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch16.tab4_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch16.tab4_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch16.tab4_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch16.tab4_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.tab4_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95 % CI)</th><th id="hd_h_ch16.tab4_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch16.tab4_1_1_1_5" id="hd_h_ch16.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with follow-up only</th><th headers="hd_h_ch16.tab4_1_1_1_5" id="hd_h_ch16.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with RFA (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>ml</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>164</p>
|
|
<p>(2 studies)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊕</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab4_1_1_1_5 hd_h_ch16.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean nodule volume in the control groups was</p>
|
|
<p>21.5 ml</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_5 hd_h_ch16.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean nodule volume in the intervention groups was</p>
|
|
<p>10.8ml lower</p>
|
|
<p>(12.14 to 9.45 lower)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hypothyroidism</td><td headers="hd_h_ch16.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>84</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>2</sup><sup>,</sup><sup>3</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not estimable</td><td headers="hd_h_ch16.tab4_1_1_1_5 hd_h_ch16.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1000</td><td headers="hd_h_ch16.tab4_1_1_1_5 hd_h_ch16.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">not estimable<sup>1</sup></td></tr><tr><td headers="hd_h_ch16.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hyperthyroidism</td><td headers="hd_h_ch16.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>84</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>2</sup><sup>,</sup><sup>3</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 7.39 (0.15 to 372.38)</td><td headers="hd_h_ch16.tab4_1_1_1_5 hd_h_ch16.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1000</td><td headers="hd_h_ch16.tab4_1_1_1_5 hd_h_ch16.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>23 more per 1000</p>
|
|
<p>(from 40 fewer to 90 more)<sup>4</sup></p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Compressive symptoms</p>
|
|
<p>VAS (0-10, higher is worse)</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>164</p>
|
|
<p>(2 studies)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>2</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab4_1_1_1_5 hd_h_ch16.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean compressive symptoms in the control groups was</p>
|
|
<p>3.1</p>
|
|
</td><td headers="hd_h_ch16.tab4_1_1_1_5 hd_h_ch16.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean compressive symptoms in the intervention groups was</p>
|
|
<p>2.8 lower</p>
|
|
<p>(3.3 to 2.31 lower)</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.tab4_1"><p class="no_margin">Zero events in either arm</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.tab4_2"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.tab4_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="ch16.tab4_4"><p class="no_margin">Zero events in control arm</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16tab5"><div id="ch16.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Clinical evidence summary: Laser ablation vs follow-up only, non-cystic nodules</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab5_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab5_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch16.tab5_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch16.tab5_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch16.tab5_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch16.tab5_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch16.tab5_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch16.tab5_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.tab5_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95 % CI)</th><th id="hd_h_ch16.tab5_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch16.tab5_1_1_1_5" id="hd_h_ch16.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with Follow-up only</th><th headers="hd_h_ch16.tab5_1_1_1_5" id="hd_h_ch16.tab5_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with LA (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Change in nodule volume</p>
|
|
<p>ml</p>
|
|
</td><td headers="hd_h_ch16.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>41</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>1</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab5_1_1_1_5 hd_h_ch16.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean change in nodule volume in the control groups was</p>
|
|
<p>0.7 ml</p>
|
|
</td><td headers="hd_h_ch16.tab5_1_1_1_5 hd_h_ch16.tab5_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean change in nodule volume in the intervention groups was</p>
|
|
<p>5.9 lower</p>
|
|
<p>(7.54 to 4.26 lower)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Improvement in symptoms</td><td headers="hd_h_ch16.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>41</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>3</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 24.5 (5.9 to 101.6)</td><td headers="hd_h_ch16.tab5_1_1_1_5 hd_h_ch16.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab5_1_1_1_5 hd_h_ch16.tab5_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>810 more per 1000</p>
|
|
<p>(from 60 more to 1000 more)<sup>2</sup></p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.tab5_1"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.tab5_2"><p class="no_margin">Zero events in control arm</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.tab5_3"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16tab6"><div id="ch16.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Clinical evidence summary: Laser ablation vs levothyroxine, non-cystic nodules</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab6_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch16.tab6_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch16.tab6_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch16.tab6_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch16.tab6_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch16.tab6_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch16.tab6_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.tab6_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95 % CI)</th><th id="hd_h_ch16.tab6_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch16.tab6_1_1_1_5" id="hd_h_ch16.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with T4</th><th headers="hd_h_ch16.tab6_1_1_1_5" id="hd_h_ch16.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with LA (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Change in nodule volume</p>
|
|
<p>ml</p>
|
|
</td><td headers="hd_h_ch16.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>42</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>1</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab6_1_1_1_5 hd_h_ch16.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean change in nodule volume in the control groups was</p>
|
|
<p>−0.6 ml</p>
|
|
</td><td headers="hd_h_ch16.tab6_1_1_1_5 hd_h_ch16.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean change in nodule volume in the intervention groups was</p>
|
|
<p>4.6ml lower</p>
|
|
<p>(6. 25 to 2.95 lower)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Improvement in symptoms</td><td headers="hd_h_ch16.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>42</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>2</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_ch16.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 6.09 (1.64 to 22.62)</td><td headers="hd_h_ch16.tab6_1_1_1_5 hd_h_ch16.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">133 per 1000</td><td headers="hd_h_ch16.tab6_1_1_1_5 hd_h_ch16.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>677 more per 1000</p>
|
|
<p>(from 85 more to 1000 more)</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.tab6_1"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.tab6_2"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16tab7"><div id="ch16.tab7" class="table"><h3><span class="label">Table 7</span><span class="title">Clinical evidence summary: Percutaneous ethanol injection vs levothyroxine, non-cystic nodules</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab7_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab7_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch16.tab7_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch16.tab7_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch16.tab7_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch16.tab7_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch16.tab7_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch16.tab7_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.tab7_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95 % CI)</th><th id="hd_h_ch16.tab7_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch16.tab7_1_1_1_5" id="hd_h_ch16.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with T4</th><th headers="hd_h_ch16.tab7_1_1_1_5" id="hd_h_ch16.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with PEI (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Reduction in nodule volume</p>
|
|
<p>% changes</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>50</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab7_1_1_1_5 hd_h_ch16.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean reduction in nodule volume in the control groups was 9 %</td><td headers="hd_h_ch16.tab7_1_1_1_5 hd_h_ch16.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean reduction in nodule volume in the intervention groups was</p>
|
|
<p>38 higher</p>
|
|
<p>(19.08 to 56.92 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Compressive symptoms</p>
|
|
<p>Any improvement</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>44</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.55 (0.96 to 2.49)</td><td headers="hd_h_ch16.tab7_1_1_1_5 hd_h_ch16.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">500 per 1000</td><td headers="hd_h_ch16.tab7_1_1_1_5 hd_h_ch16.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>275 more per 1000</p>
|
|
<p>(from 20 fewer to 745 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain</p>
|
|
<p>On procedure</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>50</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>1</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 43.35 (14.45 to 130.02)</td><td headers="hd_h_ch16.tab7_1_1_1_5 hd_h_ch16.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1000</td><td headers="hd_h_ch16.tab7_1_1_1_5 hd_h_ch16.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>960 more per 1000</p>
|
|
<p>(from 860 more to 1000 more)<sup>3</sup></p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Hyperthyroidism</p>
|
|
<p>Presence of symptoms</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>50</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 0.11 (0.2 to 0.71)</td><td headers="hd_h_ch16.tab7_1_1_1_5 hd_h_ch16.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">200 per 1000</td><td headers="hd_h_ch16.tab7_1_1_1_5 hd_h_ch16.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>173 fewer per 1000</p>
|
|
<p>(from 49 fewer to 152 fewer)</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.tab7_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.tab7_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.tab7_3"><p class="no_margin">Zero events in control arm</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16tab8"><div id="ch16.tab8" class="table"><h3><span class="label">Table 8</span><span class="title">Clinical evidence summary: HIFU vs surgery, non-cystic nodules, NRS</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab8_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab8_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch16.tab8_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch16.tab8_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch16.tab8_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch16.tab8_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch16.tab8_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch16.tab8_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.tab8_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_ch16.tab8_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch16.tab8_1_1_1_5" id="hd_h_ch16.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with Surgery</th><th headers="hd_h_ch16.tab8_1_1_1_5" id="hd_h_ch16.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with HIFU (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nodule volume (% reduction)</td><td headers="hd_h_ch16.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>154</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>2</sup></p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean nodule volume (% reduction) in the control groups was</p>
|
|
<p>100 %</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean nodule volume (% reduction) in the intervention groups was</p>
|
|
<p>36 less 1</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hypothyroidism</td><td headers="hd_h_ch16.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>154</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>2</sup><sup>,</sup><sup>3</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 0.13 (0.02 to 0.94)</td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52 per 1000</td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>45 fewer per 1000</p>
|
|
<p>(from 3 fewer to 51 fewer)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RLN palsy (temporary)</td><td headers="hd_h_ch16.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>154</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>2</sup><sup>,</sup><sup>3</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1 (0.21 to 4.8)</td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39 per 1000</td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>0 fewer per 1000</p>
|
|
<p>(from 31 fewer to 148 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bleeding (requiring re-exploration)</td><td headers="hd_h_ch16.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>154</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>2</sup><sup>,</sup><sup>3</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 0.14 (0 to 6.82)</td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">13 per 1000</td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>11 fewer per 1000</p>
|
|
<p>(from 13 fewer to 69 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Infection</td><td headers="hd_h_ch16.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>154</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>4</sup></p>
|
|
<p>due to imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not estimable</td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">not estimable<sup>4</sup></td></tr><tr><td headers="hd_h_ch16.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Improvement in symptoms (any increase</p>
|
|
<p>(slight/moderate/significant)</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>154</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>3</sup><sup>,</sup><sup>5</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.09 (0.98 to 1.21)</td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">870 per 1000</td><td headers="hd_h_ch16.tab8_1_1_1_5 hd_h_ch16.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>78 more per 1000</p>
|
|
<p>(from 17 fewer to 183 more)</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.tab8_1"><p class="no_margin">95% confidence intervals cannot be calculated as no SD available for surgery (all participants with whole nodule removed), therefore there is no forest plot displayed in the appendix.</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.tab8_2"><p class="no_margin">No additional risk of bias beyond default selection bias for non-randomised studies</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.tab8_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="ch16.tab8_4"><p class="no_margin">Zero events in either arm</p></div></dd></dl><dl class="bkr_refwrap"><dt>5</dt><dd><div id="ch16.tab8_5"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16tab9"><div id="ch16.tab9" class="table"><h3><span class="label">Table 9</span><span class="title">Clinical evidence summary: Radiofrequency ablation vs percutaneous ethanol injection, cystic nodules</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab9/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab9_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab9_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch16.tab9_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch16.tab9_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch16.tab9_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch16.tab9_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch16.tab9_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch16.tab9_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.tab9_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_ch16.tab9_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch16.tab9_1_1_1_5" id="hd_h_ch16.tab9_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with PEI</th><th headers="hd_h_ch16.tab9_1_1_1_5" id="hd_h_ch16.tab9_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with RFA (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Nodule volume</p>
|
|
<p>% reduction</p>
|
|
</td><td headers="hd_h_ch16.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>88</p>
|
|
<p>(2 studies)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>1</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_ch16.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab9_1_1_1_5 hd_h_ch16.tab9_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean nodule reduction in the control groups was</p>
|
|
<p>90 %</p>
|
|
</td><td headers="hd_h_ch16.tab9_1_1_1_5 hd_h_ch16.tab9_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean nodule reduction in the intervention groups was</p>
|
|
<p>3.15 lower</p>
|
|
<p>(5.97 to 0.33 lower)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Compressive symptoms VAS, 0-10, higher is worse</td><td headers="hd_h_ch16.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>89</p>
|
|
<p>(2 studies)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab9_1_1_1_5 hd_h_ch16.tab9_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean compressive symptoms in the control groups was</p>
|
|
<p>0.6</p>
|
|
</td><td headers="hd_h_ch16.tab9_1_1_1_5 hd_h_ch16.tab9_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean compressive symptoms in the intervention groups was</p>
|
|
<p>0.2 lower</p>
|
|
<p>(0.55 lower to 0.15 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain</p>
|
|
<p>Mild or greater, during procedure</p>
|
|
</td><td headers="hd_h_ch16.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>50</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊕⊝</p>
|
|
<p>MODERATE<sup>1</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_ch16.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 29.35 (9.65 to 89.23)</td><td headers="hd_h_ch16.tab9_1_1_1_5 hd_h_ch16.tab9_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1000</td><td headers="hd_h_ch16.tab9_1_1_1_5 hd_h_ch16.tab9_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>840 more per 1000</p>
|
|
<p>(from 690 more to 990 more)<sup>3</sup></p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.tab9_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.tab9_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.tab9_3"><p class="no_margin">Zero events in control arm</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16tab10"><div id="ch16.tab10" class="table"><h3><span class="label">Table 10</span><span class="title">Clinical evidence summary: Radiofrequency ablation vs surgery, nodule type unspecified, NRS</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab10/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab10_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab10_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch16.tab10_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch16.tab10_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch16.tab10_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch16.tab10_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch16.tab10_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch16.tab10_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.tab10_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95 % CI)</th><th id="hd_h_ch16.tab10_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch16.tab10_1_1_1_5" id="hd_h_ch16.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with Surgery</th><th headers="hd_h_ch16.tab10_1_1_1_5" id="hd_h_ch16.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with RFA (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life</p>
|
|
<p>SF-36, general health, 0-100, higher is better</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>216</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab10_1_1_1_5 hd_h_ch16.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life in the control groups was</p>
|
|
<p>66.7</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_5 hd_h_ch16.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life in the intervention groups was</p>
|
|
<p>1.8 higher</p>
|
|
<p>(0.2 to 3.4 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life</p>
|
|
<p>SF-36, vitality, 0-100, higher is better</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>216</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab10_1_1_1_5 hd_h_ch16.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life in the control groups was</p>
|
|
<p>67.5</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_5 hd_h_ch16.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life in the intervention groups was</p>
|
|
<p>3.8 higher</p>
|
|
<p>(1.56 to 6.04 higher)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life</p>
|
|
<p>SF-36, mental health, 0-100, higher is better</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>216</p>
|
|
<p>(1 study)</p>
|
|
<p>6 months</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab10_1_1_1_5 hd_h_ch16.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life in the control groups was</p>
|
|
<p>79.3</p>
|
|
</td><td headers="hd_h_ch16.tab10_1_1_1_5 hd_h_ch16.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean quality of life in the intervention groups was</p>
|
|
<p>1.6 higher</p>
|
|
<p>(0.11 to 3.09 higher)</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.tab10_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.tab10_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16tab11"><div id="ch16.tab11" class="table"><h3><span class="label">Table 11</span><span class="title">Clinical evidence summary: Microwave ablation vs surgery, nodule type unspecified, RCT</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab11/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab11_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab11_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch16.tab11_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch16.tab11_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch16.tab11_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch16.tab11_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch16.tab11_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch16.tab11_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.tab11_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95 % CI)</th><th id="hd_h_ch16.tab11_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch16.tab11_1_1_1_5" id="hd_h_ch16.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with Surgery</th><th headers="hd_h_ch16.tab11_1_1_1_5" id="hd_h_ch16.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Microwave ablation (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nodule volume</td><td headers="hd_h_ch16.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>52</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch16.tab11_1_1_1_5 hd_h_ch16.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">See footnote <sup>3</sup></td><td headers="hd_h_ch16.tab11_1_1_1_5 hd_h_ch16.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>The mean final nodule volume in the intervention groups was 0.69ml</p>
|
|
<p>(SD 0.89) compared with baseline</p>
|
|
<p>17.1 ml (SD 14.4)<sup>3</sup></p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hoarseness (temporary)</td><td headers="hd_h_ch16.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>52</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊝⊝⊝</p>
|
|
<p>VERY LOW<sup>1</sup><sup>,</sup><sup>2</sup></p>
|
|
<p>due to risk of bias, imprecision</p>
|
|
</td><td headers="hd_h_ch16.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.43 (0.04 to 4.44)</td><td headers="hd_h_ch16.tab11_1_1_1_5 hd_h_ch16.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83 per 1000</td><td headers="hd_h_ch16.tab11_1_1_1_5 hd_h_ch16.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>47 fewer per 1000</p>
|
|
<p>(from 80 fewer to 286 more)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Post-operative pain (temporary)</td><td headers="hd_h_ch16.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>52</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>1</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_ch16.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.08 (0.02 to 0.30)</td><td headers="hd_h_ch16.tab11_1_1_1_5 hd_h_ch16.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">917 per 1000</td><td headers="hd_h_ch16.tab11_1_1_1_5 hd_h_ch16.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>844 fewer per 1000</p>
|
|
<p>(from 642 fewer to 899 fewer)</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Resolution of compressive symptoms</td><td headers="hd_h_ch16.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>21</p>
|
|
<p>(1 study)</p>
|
|
<p>12 months</p>
|
|
</td><td headers="hd_h_ch16.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⊕⊕⊝⊝</p>
|
|
<p>LOW<sup>1</sup></p>
|
|
<p>due to risk of bias</p>
|
|
</td><td headers="hd_h_ch16.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1 (0.84 to 1.19)</td><td headers="hd_h_ch16.tab11_1_1_1_5 hd_h_ch16.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1000 per 1000</td><td headers="hd_h_ch16.tab11_1_1_1_5 hd_h_ch16.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>0 fewer per 1000</p>
|
|
<p>(from 160 fewer to 190 more)</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.tab11_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.tab11_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.tab11_3"><p class="no_margin">95% confidence intervals cannot be calculated as no SD available for surgery (all participants with whole nodule removed)</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16tab12"><div id="ch16.tab12" class="table"><h3><span class="label">Table 12</span><span class="title">UK costs of thyroid enlargement drugs</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab12/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab12_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Drug</th><th id="hd_h_ch16.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Daily dose</th><th id="hd_h_ch16.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost per Month</th><th id="hd_h_ch16.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost per Year</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Levothyroxine (T<sub>4</sub>)</td><td headers="hd_h_ch16.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100µg once daily<sup>(a)</sup></td><td headers="hd_h_ch16.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1.03</td><td headers="hd_h_ch16.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£13.43</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Source: BNF, August 2019.</p></div></dd></dl><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="ch16.tab12_1"><p class="no_margin">Maintenance dose 100-200mcg once daily</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16tab13"><div id="ch16.tab13" class="table"><h3><span class="label">Table 13</span><span class="title">UK costs of hospital procedures</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.tab13/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.tab13_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><th id="hd_h_ch16.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unit costs</th></tr></thead><tbody><tr><td headers="hd_h_ch16.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Radiofrequency Ablation <sup>(a)</sup></td><td headers="hd_h_ch16.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£733.53</td></tr><tr><td headers="hd_h_ch16.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Radioactive iodine <sup>(b)</sup></td><td headers="hd_h_ch16.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£286.32</td></tr><tr><td headers="hd_h_ch16.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Surgery (Thyroid Procedures with CC Score 0-4+)<sup>(c)</sup></td><td headers="hd_h_ch16.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3,689</td></tr><tr><td headers="hd_h_ch16.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ethanol ablation <sup>(d)</sup></td><td headers="hd_h_ch16.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£91.91 <sup>(e)</sup></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Source: NHS reference costs 2016-17, total HRG schedule <a class="bibr" href="#ch16.ref14" rid="ch16.ref14"><sup>14</sup></a>.</p></div></dd></dl><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="ch16.tab13_1"><p class="no_margin">Cost code AB15Z, Radiofrequency Ablation or Cryoablation, for Pain Management</p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="ch16.tab13_2"><p class="no_margin">Cost code RN51Z, Oral Delivery of Radiotherapy for Thyroid Ablation</p></div></dd></dl><dl class="bkr_refwrap"><dt>(c)</dt><dd><div id="ch16.tab13_3"><p class="no_margin">Weighted average of all 3 combined thyroid procedures with CC scores 0-1, 2-3, 4+(KA09C, KA09D, KA09E) including excess bed days and the average length of stay is 1.6 days</p></div></dd></dl><dl class="bkr_refwrap"><dt>(d)</dt><dd><div id="ch16.tab13_4"><p class="no_margin">Cost code RD42Z, Ultrasound Scan with duration of 20 minutes and over, without Contrast plus cost of ethanol BP, Martindale pharmaceuticals</p></div></dd></dl><dl class="bkr_refwrap"><dt>(e)</dt><dd><div id="ch16.tab13_5"><p class="no_margin">Ultrasound £59.91 + ethanol ampule 20ml (5ml *4) £32</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16appatab1"><div id="ch16.appa.tab1" class="table"><h3><span class="label">Table 14</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appa.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appa.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ID</th><th id="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Field</th><th id="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Content</th></tr></thead><tbody><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">I</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review questions</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Which people with non-malignant thyroid enlargement should be referred for surgery?</p>
|
|
<p>What is the clinical and cost effectiveness of non-surgical treatments (e.g. radiofrequency ablation, high intensity focused ultrasound) for non-malignant thyroid enlargement?</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">II</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of review question</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Intervention</p>
|
|
<p>A review of health economic evidence related to the same review question was conducted in parallel with this review. For details see the health economic review protocol for this NICE guideline.</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">III</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Objective of the review</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Determine the most clinically and cost effective way to manage non-malignant thyroid enlargement</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IV</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – population / disease / condition / issue / domain</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People with non-malignant thyroid enlargement</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">V</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – intervention(s) / exposure(s) / prognostic factor(s)</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Surgery</p>
|
|
<p>Radiofrequency ablation</p>
|
|
<p>High intensity focused ultrasound</p>
|
|
<p>Ethanol ablation</p>
|
|
<p>Radioiodine ablation</p>
|
|
<p>Levothyroxine therapy</p>
|
|
<p>Microwave ablation</p>
|
|
<p>Laser ablation</p>
|
|
<p>Monitoring only</p>
|
|
<p>Placebo/sham</p>
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</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VI</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – comparator(s) / control or reference (gold) standard</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Any of above vs any other</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VII</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and prioritisation</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p><b>Critical</b>
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<ul id="ch16.l4"><li id="ch16.lt17" class="half_rhythm"><div>Mortality (dichotomous, ≥1 year)</div></li><li id="ch16.lt18" class="half_rhythm"><div>Quality of life (continuous)</div></li></ul></p>
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<p><b>Important</b>
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<ul id="ch16.l5"><li id="ch16.lt19" class="half_rhythm"><div>Percent change in volume of nodule/goitre (continuous)</div></li><li id="ch16.lt20" class="half_rhythm"><div>Malignancy (dichotomous)</div></li><li id="ch16.lt21" class="half_rhythm"><div>Hypothyroidism (dichotomous)</div></li><li id="ch16.lt22" class="half_rhythm"><div>Hyperthyroidism (dichotomous)</div></li><li id="ch16.lt23" class="half_rhythm"><div>Hypoparathyroidism (dichotomous)</div></li><li id="ch16.lt24" class="half_rhythm"><div>Recurrent laryngeal nerve damage (dichotomous)</div></li><li id="ch16.lt25" class="half_rhythm"><div>Bleeding (dichotomous)</div></li><li id="ch16.lt26" class="half_rhythm"><div>Infection (dichotomous)</div></li><li id="ch16.lt27" class="half_rhythm"><div>Arrhythmia (dichotomous)</div></li><li id="ch16.lt28" class="half_rhythm"><div>Osteoporosis (dichotomous)</div></li><li id="ch16.lt29" class="half_rhythm"><div>Pain (continuous)</div></li><li id="ch16.lt30" class="half_rhythm"><div>Compressive symptoms (continuous)</div></li><li id="ch16.lt31" class="half_rhythm"><div>Patient/family/carer experience (continuous)</div></li></ul></p>
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<p>Minimum duration as for the minimum duration for inclusion of studies unless specified.</p></td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VIII</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – study design</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch16.l6"><li id="ch16.lt32" class="half_rhythm"><div>RCTs preferred, if no RCTs available (on an intervention by intervention basis) to consider non-randomised cohort studies in which key confounders (age, sex, co-existing conditions, size of nodule, type of nodule) are addressed, either through restriction (see stratifications below) or appropriate matching/statistical adjustment</div></li><li id="ch16.lt33" class="half_rhythm"><div>Minimum duration of 3 months</div></li><li id="ch16.lt34" class="half_rhythm"><div>Crossover studies excluded</div></li></ul>
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</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">IX</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Other inclusion</p>
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<p>exclusion criteria</p>
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</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">X</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity / subgroup analysis, or metaregression</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p><b>Stratifications</b>
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<ul id="ch16.l7"><li id="ch16.lt35" class="half_rhythm"><div>Nodule vs goitre</div></li><li id="ch16.lt36" class="half_rhythm"><div>Age - children (4-18), adults (>18-65), older adults (>65)</div></li><li id="ch16.lt37" class="half_rhythm"><div>Type of nodule (cystic vs non-cystic)</div></li></ul></p>
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<p><b>Subgroup analyses</b>
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<ul id="ch16.l8"><li id="ch16.lt38" class="half_rhythm"><div>Age subdivisions (18-50, 50-65, 65-85, >85)</div></li><li id="ch16.lt39" class="half_rhythm"><div>Surgical indications (compressive symptoms, cosmesis, uncertainty in diagnosis)</div></li></ul></p>
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</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XI</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Selection process – duplicate screening / selection / analysis</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch16.l9"><li id="ch16.lt40" class="half_rhythm"><div>A sample of at least 10% of the abstract lists were double-sifted by a senior research fellow and discrepancies rectified, with committee input where consensus could not be reached, for more information please see the separate Methods report for this guideline.</div></li></ul>
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</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XII</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data management (software)</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Pairwise meta-analyses were performed using Cochrane Review Manager (RevMan5).</p>
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<p>GRADEpro was used to assess the quality of evidence for each outcome.</p>
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<p>Endnote was used for bibliography, citations, sifting and reference management</p>
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</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XIII</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Information sources – databases and dates</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch16.l10"><li id="ch16.lt41" class="half_rhythm"><div>Medline, Embase and The Cochrane Library</div></li></ul>
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</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XIV</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Identify if an update</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not an update</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XV</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10074" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/indevelopment/gid-ng10074</a>
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</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XVI</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Highlight if amendment to previous protocol</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not an amendment</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XVII</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search strategy – for one database</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#ch16.appb">Appendix B</a>:</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XVIII</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data collection process – forms / duplicate</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A standardised evidence table format will be used and published as <a href="#ch16.appd">Appendix D</a>: of the evidence report.</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XIX</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data items – define all variables to be collected</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see evidence tables in <a href="#ch16.appd">Appendix D</a>: (clinical evidence tables) or <a href="#ch16.apph">Appendix H</a>: (health economic evidence tables).</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XX</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for assessing bias at outcome / study level</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Standard study checklists were used to critically appraise individual studies. For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a></p>
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<p>The risk of bias across all available evidence was evaluated for each outcome using an adaptation of the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) toolbox’ developed by the international GRADE working group <a href="http://www.gradeworkinggroup.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.gradeworkinggroup.org/</a></p>
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</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XXI</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criteria for quantitative synthesis</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.4 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XXII</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for quantitative analysis – combining studies and exploring (in)consistency</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the separate Methods report for this guideline.</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XXIII</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-bias assessment – publication bias, selective reporting bias</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XXIV</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Confidence in cumulative evidence</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see sections 6.4 and 9.1 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XXV</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rationale / context – what is known</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the introduction to the evidence review.</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XXVI</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Describe contributions of authors and guarantor</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>A <a href="https://www.nice.org.uk/guidance/ng145/documents" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">multidisciplinary committee</a> developed the evidence review. The committee was convened by the National Guideline Centre (NGC) and chaired by Sarah Fishburn in line with section 3 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1%20Introduction%20and%20overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</p>
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<p>Staff from NGC undertook systematic literature searches, appraised the evidence, conducted meta-analysis and cost-effectiveness analysis where appropriate, and drafted the evidence review in collaboration with the committee. For details please see <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</p>
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</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XXVII</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sources of funding / support</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NGC is funded by NICE and hosted by the Royal College of Physicians.</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XXVIII</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Name of sponsor</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NGC is funded by NICE and hosted by the Royal College of Physicians.</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XXIX</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Roles of sponsor</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds NGC to develop guidelines for those working in the NHS, public health and social care in England.</td></tr><tr><td headers="hd_h_ch16.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">XXX</td><td headers="hd_h_ch16.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PROSPERO registration number</td><td headers="hd_h_ch16.appa.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not registered</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16appatab2"><div id="ch16.appa.tab2" class="table"><h3><span class="label">Table 15</span><span class="title">Health economic review protocol</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appa.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appa.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch16.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Review question</th><th id="hd_h_ch16.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">All questions – health economic evidence</th></tr></thead><tbody><tr><td headers="hd_h_ch16.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Objectives</b>
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</td><td headers="hd_h_ch16.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">To identify health economic studies relevant to any of the review questions.</td></tr><tr><td headers="hd_h_ch16.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Search criteria</b>
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</td><td headers="hd_h_ch16.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch16.l11"><li id="ch16.lt42" class="half_rhythm"><div>Populations, interventions and comparators must be as specified in the clinical review protocol above.</div></li><li id="ch16.lt43" class="half_rhythm"><div>Studies must be of a relevant health economic study design (cost–utility analysis, cost-effectiveness analysis, cost–benefit analysis, cost–consequences analysis, comparative cost analysis).</div></li><li id="ch16.lt44" class="half_rhythm"><div>Studies must not be a letter, editorial or commentary, or a review of health economic evaluations. (Recent reviews will be ordered although not reviewed. The bibliographies will be checked for relevant studies, which will then be ordered.)</div></li><li id="ch16.lt45" class="half_rhythm"><div>Unpublished reports will not be considered unless submitted as part of a call for evidence.</div></li><li id="ch16.lt46" class="half_rhythm"><div>Studies must be in English.</div></li></ul>
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</td></tr><tr><td headers="hd_h_ch16.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Search strategy</b>
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</td><td headers="hd_h_ch16.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A health economic study search will be undertaken using population-specific terms and a health economic study filter – see <a href="#ch16.appb">Appendix B</a>: below.</td></tr><tr><td headers="hd_h_ch16.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Review strategy</b>
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</td><td headers="hd_h_ch16.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Studies not meeting any of the search criteria above will be excluded. Studies published before 2003, abstract-only studies and studies from non-OECD countries or the USA will also be excluded.</p><p>Each remaining study will be assessed for applicability and methodological limitations using the NICE economic evaluation checklist which can be found in <a href="#ch16.apph">appendix H</a> of Developing NICE guidelines: the manual (2014).<a class="bibr" href="#ch16.ref37" rid="ch16.ref37"><sup>37</sup></a></p><p><b>Inclusion and exclusion criteria</b>
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<ul id="ch16.l12"><li id="ch16.lt47" class="half_rhythm"><div>If a study is rated as both ‘Directly applicable’ and with ‘Minor limitations’ then it will be included in the guideline. A health economic evidence table will be completed and it will be included in the health economic evidence profile.</div></li><li id="ch16.lt48" class="half_rhythm"><div>If a study is rated as either ‘Not applicable’ or with ‘Very serious limitations’ then it will usually be excluded from the guideline. If it is excluded then a health economic evidence table will not be completed and it will not be included in the health economic evidence profile.</div></li><li id="ch16.lt49" class="half_rhythm"><div>If a study is rated as ‘Partially applicable’, with ‘Potentially serious limitations’ or both then there is discretion over whether it should be included.</div></li></ul></p>
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<p><b>Where there is discretion</b></p><p>The health economist will make a decision based on the relative applicability and quality of the available evidence for that question, in discussion with the guideline committee if required. The ultimate aim is to include health economic studies that are helpful for decision-making in the context of the guideline and the current NHS setting. If several studies are considered of sufficiently high applicability and methodological quality that they could all be included, then the health economist, in discussion with the committee if required, may decide to include only the most applicable studies and to selectively exclude the remaining studies. All studies excluded on the basis of applicability or methodological limitations will be listed with explanation in the excluded health economic studies appendix below.</p><p>The health economist will be guided by the following hierarchies.</p><p><i>Setting:</i>
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<ul id="ch16.l13"><li id="ch16.lt50" class="half_rhythm"><div>UK NHS (most applicable).</div></li><li id="ch16.lt51" class="half_rhythm"><div>OECD countries with predominantly public health insurance systems (for example, France, Germany, Sweden).</div></li><li id="ch16.lt52" class="half_rhythm"><div>OECD countries with predominantly private health insurance systems (for example, Switzerland).</div></li><li id="ch16.lt53" class="half_rhythm"><div>Studies set in non-OECD countries or in the USA will be excluded before being assessed for applicability and methodological limitations.</div></li></ul></p>
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<p><i>Health economic study type:</i>
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<ul id="ch16.l14"><li id="ch16.lt54" class="half_rhythm"><div>Cost–utility analysis (most applicable).</div></li><li id="ch16.lt55" class="half_rhythm"><div>Other type of full economic evaluation (cost–benefit analysis, cost-effectiveness analysis, cost–consequences analysis).</div></li><li id="ch16.lt56" class="half_rhythm"><div>Comparative cost analysis.</div></li><li id="ch16.lt57" class="half_rhythm"><div>Non-comparative cost analyses including cost-of-illness studies will be excluded before being assessed for applicability and methodological limitations.</div></li></ul></p>
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<p><i>Year of analysis:</i>
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<ul id="ch16.l15"><li id="ch16.lt58" class="half_rhythm"><div>The more recent the study, the more applicable it will be.</div></li><li id="ch16.lt59" class="half_rhythm"><div>Studies published in 2003 or later but that depend on unit costs and resource data entirely or predominantly from before 2003 will be rated as ‘Not applicable’.</div></li><li id="ch16.lt60" class="half_rhythm"><div>Studies published before 2003 will be excluded before being assessed for applicability and methodological limitations.</div></li></ul></p>
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<p><i>Quality and relevance of effectiveness data used in the health economic analysis:</i>
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<ul id="ch16.l16"><li id="ch16.lt61" class="half_rhythm"><div>The more closely the clinical effectiveness data used in the health economic analysis match with the outcomes of the studies included in the clinical review the more useful the analysis will be for decision-making in the guideline.</div></li></ul></p></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16appbtab1"><div id="ch16.appb.tab1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch16.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ch16.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ch16.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_ch16.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline (OVID)</td><td headers="hd_h_ch16.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1946 – 07 January 2019</td><td headers="hd_h_ch16.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Exclusions</p>
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<p>Randomised controlled trials</p>
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<p>Systematic review studies</p>
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<p>Observational studies</p>
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</td></tr><tr><td headers="hd_h_ch16.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase (OVID)</td><td headers="hd_h_ch16.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1974 – 07 January 2019</td><td headers="hd_h_ch16.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Exclusions</p>
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<p>Randomised controlled trials</p>
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<p>Systematic review studies</p>
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<p>Observational studies</p>
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</td></tr><tr><td headers="hd_h_ch16.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The Cochrane Library (Wiley)</td><td headers="hd_h_ch16.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Cochrane Reviews to 2019 Issue 1 or 12</p>
|
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<p>CENTRAL to 2019 Issue 1 or 12</p>
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<p>DARE, and NHSEED to 2015 Issue 2 of 4</p>
|
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<p>HTA to 2016 Issue 2 of 4</p>
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</td><td headers="hd_h_ch16.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16appbtab2"><div id="ch16.appb.tab2" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appb.tab2_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((thyroid adj4 (swell* or enlarg* or nodule* or node*)) or (goitre* or goiter*)) adj5 (non-malignan* or nonmalignan* or benign)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Thyroid Nodule/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 or 2</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/4-11</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12 not 13</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experimentation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Models, Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/14-20</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3 not 21</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Thyroidectomy/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(thyroidectomy or total thryoidectomy or total-thyroidectomy or lobectomy or hemithyroidectomy or hemi-thyroidectomy or near total thryoidectomy or near-total thyroidectomy or isthmusectomy or surg* or interstitial laser photocoagulation or ILP).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((radioiodine or microwave or radiofrequency or ethanol) adj3 ablation).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(radioactive iodine or RAI).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High-Intensity Focused Ultrasound Ablation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(high intensity focused ultrasound or HIFU).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(Magnetic resonance guided focused ultrasound or MRgFUS).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(percutaneous ethanol injection or PEI).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">levothyroxine.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/23-31</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22 and 32</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">controlled clinical trial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomi#ed.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">placebo.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomly.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clinical Trials as topic.sh.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">trial.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/34-40</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Meta-Analysis as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(meta analy* or metanaly* or metaanaly* or meta regression).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((systematic* or evidence*) adj3 (review* or overview*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(reference list* or bibliograph* or hand search* or manual search* or relevant journals).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search strategy or search criteria or systematic search or study selection or data extraction).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search* adj4 literature).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(medline or pubmed or cochrane or embase or psychlit or psyclit or psychinfo or psycinfo or cinahl or science citation index or bids or cancerlit).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cochrane.jw.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((multiple treatment* or indirect or mixed) adj2 comparison*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/42-51</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Epidemiologic studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Observational study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Cohort studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cohort adj (study or studies or analys* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((follow up or observational or uncontrolled or non randomi#ed or epidemiologic*) adj (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((longitudinal or retrospective or prospective or cross sectional) and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Controlled Before-After Studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Historically Controlled Study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interrupted Time Series Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(before adj2 after adj2 (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/53-62</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp case control study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case control*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/64-65</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63 or 66</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cross-sectional studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cross sectional and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/68-69</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63 or 70</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63 or 66 or 70</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33 and (41 or 52 or 72)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 73 to English language</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16appbtab3"><div id="ch16.appb.tab3" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appb.tab3_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((thyroid adj4 (swell* or enlarg* or nodule* or node*)) or (goitre* or goiter*)) adj5 (non-malignan* or nonmalignan* or benign)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Thyroid Nodule/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 or 2</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/4-8</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9 not 10</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/11-18</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3 not 19</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Thyroidectomy/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(thyroidectomy or total thryoidectomy or total-thyroidectomy or lobectomy or hemithyroidectomy or hemi-thyroidectomy or near total thryoidectomy or near-total thyroidectomy or isthmusectomy or surg* or interstitial laser photocoagulation or ILP).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((radioiodine or microwave or radiofrequency or ethanol) adj3 ablation).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">radioactive iodine/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(radioactive iodine or RAI).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High-Intensity Focused Ultrasound Ablation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(high intensity focused ultrasound or HIFU).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(Magnetic resonance guided focused ultrasound or MRgFUS).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(percutaneous ethanol injection or PEI).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">levothyroxine/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/21-30</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20 and 31</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">factorial*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(crossover* or cross over*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((doubl* or singl*) adj blind*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(assign* or allocat* or volunteer* or placebo*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">crossover procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">single blind procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">double blind procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/33-41</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">systematic review/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">meta-analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(meta analy* or metanaly* or metaanaly* or meta regression).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((systematic* or evidence*) adj3 (review* or overview*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(reference list* or bibliograph* or hand search* or manual search* or relevant journals).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search strategy or search criteria or systematic search or study selection or data extraction).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search* adj4 literature).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(medline or pubmed or cochrane or embase or psychlit or psyclit or psychinfo or psycinfo or cinahl or science citation index or bids or cancerlit).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cochrane.jw.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((multiple treatment* or indirect or mixed) adj2 comparison*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/43-52</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clinical study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Observational study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">family study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">longitudinal study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">retrospective study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">prospective study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cohort analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">follow-up/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cohort*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61 and 62</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cohort adj (study or studies or analys* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((follow up or observational or uncontrolled or non randomi#ed or epidemiologic*) adj (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((longitudinal or retrospective or prospective or cross sectional) and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(before adj2 after adj2 (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/54-60,63-67</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp case control study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case control*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/69-70</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68 or 71</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cross-sectional study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cross sectional and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/73-74</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68 or 75</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">77.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68 or 71 or 75</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 and (42 or 53 or 77)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">79.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 78 to English language</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16appbtab4"><div id="ch16.appb.tab4" class="table"><h3><span class="title">Cochrane Library (Wiley) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appb.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appb.tab4_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((thyroid near/4 (swell* or enlarg* or nodule* or node*)) or (goitre* or goiter*)) near/5 (non-malignan* or nonmalignan* or benign)):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Thyroid Nodule] explode all trees</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 or #2</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Thyroidectomy] explode all trees</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(“total thryoidectomy” or “total-thyroidectomy” or “lobectomy” or “hemithyroidectomy” or “hemi-thyroidectomy” or “near total thryoidectomy” or “near-total thyroidectomy” or “isthmusectomy” or “surg*” or “interstitial laser photocoagulation” or “ILP”):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(radioactive iodine or RAI):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(high intensity focused ultrasound or HIFU):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(Magnetic resonance guided focused ultrasound or MRgFUS):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(percutaneous ethanol injection or PEI):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">levothyroxine:ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #4-#10)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3 and #11</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16appbtab5"><div id="ch16.appb.tab5" class="table"><h3><span class="label">Table 16</span><span class="title">Database date parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appb.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appb.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_ch16.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ch16.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ch16.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_ch16.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline</td><td headers="hd_h_ch16.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2014 – 07 January 2019</td><td headers="hd_h_ch16.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
|
|
<p>Health economics studies</p>
|
|
<p>Health economics modelling studies</p>
|
|
<p>Quality of life studies</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase</td><td headers="hd_h_ch16.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">– 07 January 2019</td><td headers="hd_h_ch16.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
|
|
<p>Health economics studies</p>
|
|
<p>Health economics modelling studies</p>
|
|
<p>Quality of life studies</p>
|
|
</td></tr><tr><td headers="hd_h_ch16.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Centre for Research and Dissemination (CRD)</td><td headers="hd_h_ch16.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>HTA - Inception – 07 January 2019</p>
|
|
<p>NHSEED - Inception to March 2015</p>
|
|
</td><td headers="hd_h_ch16.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16appbtab6"><div id="ch16.appb.tab6" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appb.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appb.tab6_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp thyroid diseases/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">hyperthyroid*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">hypothyroid*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">thyrotoxicosis.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(thyroid adj3 (swell* or dysfunction* or enlarg* or nodule* or node* or disease* or condition* or disorder*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-5</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/7-14</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 not 16</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experimentation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Models, Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/17-23</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6 not 24</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 25 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Value of life/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp “Costs and Cost Analysis”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics, Hospital/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics, Medical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics, Nursing/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics, Pharmaceutical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp “Fees and Charges”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Budgets/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effective* or utilit* or benefit* or minimi* or unit* or estimat* or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/27-42</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp models, economic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Models, Theoretical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Models, Organizational/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">markov chains/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">monte carlo method/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Decision Theory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(markov* or monte carlo).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">econom* model*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(decision* adj2 (tree* or analy* or model*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/44-52</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">quality-adjusted life years/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">sickness impact profile/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(quality adj2 (wellbeing or well being)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">sickness impact profile.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">disability adjusted life.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(qal* or qtime* or qwb* or daly*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(euroqol* or eq5d* or eq 5*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(qol* or hql* or hqol* or h qol* or hrqol* or hr qol*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(health utility* or utility score* or disutilit* or utility value*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hui or hui1 or hui2 or hui3).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(health* year* equivalent* or hye or hyes).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">discrete choice*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">rosser.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(willingness to pay or time tradeoff or time trade off or tto or standard gamble*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sf36* or sf 36* or short form 36* or shortform 36* or shortform36*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sf20 or sf 20 or short form 20 or shortform 20 or shortform20).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sf12* or sf 12* or short form 12* or shortform 12* or shortform12*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sf8* or sf 8* or short form 8* or shortform 8* or shortform8*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sf6* or sf 6* or short form 6* or shortform 6* or shortform6*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/54-72</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26 and (43 or 53 or 73)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16appbtab7"><div id="ch16.appb.tab7" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appb.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appb.tab7_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp thyroid diseases/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">hyperthyroid*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">hypothyroid*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">thyrotoxicosis*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(thyroid adj3 (swell* or dysfunction* or enlarg* or nodule* or node* or disease* or condition* or disorder*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-5</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/7-11</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12 not 13</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/14-21</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6 not 22</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 23 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">health economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp economic evaluation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp health care cost/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp fee/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">funding/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effective* or utilit* or benefit* or minimi* or unit* or estimat* or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/25-37</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">statistical model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp economic aspect/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39 and 40</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*theoretical model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*nonbiological model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">stochastic model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">decision theory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">decision tree/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">monte carlo method/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(markov* or monte carlo).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">econom* model*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(decision* adj2 (tree* or analy* or model*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/41-50</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">quality adjusted life year/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">“quality of life index”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">short form 12/ or short form 20/ or short form 36/ or short form 8/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">sickness impact profile/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(quality adj2 (wellbeing or well being)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">sickness impact profile.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">disability adjusted life.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(qal* or qtime* or qwb* or daly*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(euroqol* or eq5d* or eq 5*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(qol* or hql* or hqol* or h qol* or hrqol* or hr qol*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(health utility* or utility score* or disutilit* or utility value*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hui or hui1 or hui2 or hui3).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(health* year* equivalent* or hye or hyes).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">discrete choice*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">rosser.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(willingness to pay or time tradeoff or time trade off or tto or standard gamble*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sf36* or sf 36* or short form 36* or shortform 36* or shortform36*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sf20 or sf 20 or short form 20 or shortform 20 or shortform20).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sf12* or sf 12* or short form 12* or shortform 12* or shortform12*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sf8* or sf 8* or short form 8* or shortform 8* or shortform8*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sf6* or sf 6* or short form 6* or shortform 6* or shortform6*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/52-72</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24 and (38 or 51 or 73)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16appbtab8"><div id="ch16.appb.tab8" class="table"><h3><span class="title">NHS EED and HTA (CRD) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appb.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appb.tab8_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">MeSH DESCRIPTOR Thyroid Diseases EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">hyperthyroid*</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">hypothyroid*</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">thyrotoxicosis*</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(thyroid adj3 (swell* or dysfunction* or enlarg* or nodule* or node* or disease* or condition* or disorder*))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">#1 OR #2 OR #3 OR #4 or #5</td></tr></tbody></table></div></div></article><article data-type="fig" id="figobch16appcfig1"><div id="ch16.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20Flow%20chart%20of%20clinical%20study%20selection%20for%20the%20review%20of%20benign%20thyroid%20enlargement.&p=BOOKS&id=577222_ch16appcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appcf1.jpg" alt="Figure 1. Flow chart of clinical study selection for the review of benign thyroid enlargement." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">Flow chart of clinical study selection for the review of benign thyroid enlargement</span></h3></div></article><article data-type="fig" id="figobch16appefig1"><div id="ch16.appe.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20Nodulevolume%20(ml%2C%206-60%20months).&p=BOOKS&id=577222_ch16appef1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef1.jpg" alt="Figure 2. Nodulevolume (ml, 6-60 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">Nodulevolume (ml, 6-60 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig2"><div id="ch16.appe.fig2" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%203.%20Nodule%20volume%20(%25%20reduction%2C%2012%20months).&p=BOOKS&id=577222_ch16appef2.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef2.jpg" alt="Figure 3. Nodule volume (% reduction, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 3</span><span class="title">Nodule volume (% reduction, 12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig3"><div id="ch16.appe.fig3" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%204.%20Thyroid%20volume%20(ml%2C%2012%20months).&p=BOOKS&id=577222_ch16appef3.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef3.jpg" alt="Figure 4. Thyroid volume (ml, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 4</span><span class="title">Thyroid volume (ml, 12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig4"><div id="ch16.appe.fig4" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%205.%20Hyperthyroidism%20(18%20months).&p=BOOKS&id=577222_ch16appef4.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef4.jpg" alt="Figure 5. Hyperthyroidism (18 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 5</span><span class="title">Hyperthyroidism (18 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig5"><div id="ch16.appe.fig5" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%206.%20Improvement%20in%20symptoms%20(12%20months).&p=BOOKS&id=577222_ch16appef5.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef5.jpg" alt="Figure 6. Improvement in symptoms (12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 6</span><span class="title">Improvement in symptoms (12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig6"><div id="ch16.appe.fig6" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%207.%20Arrhythmias%20(AF%2C%2012%20months).&p=BOOKS&id=577222_ch16appef6.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef6.jpg" alt="Figure 7. Arrhythmias (AF, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 7</span><span class="title">Arrhythmias (AF, 12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig7"><div id="ch16.appe.fig7" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%208.%20Nodule%20volume%20(ml%2C%206%20months).&p=BOOKS&id=577222_ch16appef7.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef7.jpg" alt="Figure 8. Nodule volume (ml, 6 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 8</span><span class="title">Nodule volume (ml, 6 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig8"><div id="ch16.appe.fig8" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%209.%20Hypothyroidism%20(6%20months).&p=BOOKS&id=577222_ch16appef8.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef8.jpg" alt="Figure 9. Hypothyroidism (6 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 9</span><span class="title">Hypothyroidism (6 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig9"><div id="ch16.appe.fig9" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2010.%20Hyperthyroidism%20(6%20months).&p=BOOKS&id=577222_ch16appef9.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef9.jpg" alt="Figure 10. Hyperthyroidism (6 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 10</span><span class="title">Hyperthyroidism (6 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig10"><div id="ch16.appe.fig10" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2011.%20Compressive%20symptoms%20(6%20months%2C%200-10%2C%20VAS%2C%20higher%20is%20worse).&p=BOOKS&id=577222_ch16appef10.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef10.jpg" alt="Figure 11. Compressive symptoms (6 months, 0-10, VAS, higher is worse)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 11</span><span class="title">Compressive symptoms (6 months, 0-10, VAS, higher is worse)</span></h3></div></article><article data-type="fig" id="figobch16appefig11"><div id="ch16.appe.fig11" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2012.%20Change%20in%20nodule%20volume%20(ml%2C%2012%20months).&p=BOOKS&id=577222_ch16appef11.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef11.jpg" alt="Figure 12. Change in nodule volume (ml, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 12</span><span class="title">Change in nodule volume (ml, 12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig12"><div id="ch16.appe.fig12" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2013.%20Improvement%20in%20symptoms%20(12%20months).&p=BOOKS&id=577222_ch16appef12.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef12.jpg" alt="Figure 13. Improvement in symptoms (12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 13</span><span class="title">Improvement in symptoms (12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig13"><div id="ch16.appe.fig13" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2014.%20Change%20in%20nodule%20volume%20(ml%2C%2012%20months).&p=BOOKS&id=577222_ch16appef13.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef13.jpg" alt="Figure 14. Change in nodule volume (ml, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 14</span><span class="title">Change in nodule volume (ml, 12 months)</span></h3><div class="caption"><p><Insert Note here></p></div></div></article><article data-type="fig" id="figobch16appefig14"><div id="ch16.appe.fig14" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2015.%20Improvement%20in%20symptoms%20(12%20months).&p=BOOKS&id=577222_ch16appef14.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef14.jpg" alt="Figure 15. Improvement in symptoms (12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 15</span><span class="title">Improvement in symptoms (12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig15"><div id="ch16.appe.fig15" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2016.%20Reduction%20in%20nodule%20volume%20(%25%2C%2012%20months).&p=BOOKS&id=577222_ch16appef15.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef15.jpg" alt="Figure 16. Reduction in nodule volume (%, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 16</span><span class="title">Reduction in nodule volume (%, 12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig16"><div id="ch16.appe.fig16" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2017.%20Compressive%20symptoms%20(any%20improvement%2C%2012%20months).&p=BOOKS&id=577222_ch16appef16.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef16.jpg" alt="Figure 17. Compressive symptoms (any improvement, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 17</span><span class="title">Compressive symptoms (any improvement, 12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig17"><div id="ch16.appe.fig17" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2018.%20Pain%20(on%20procedure%2C%2012%20months).&p=BOOKS&id=577222_ch16appef17.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef17.jpg" alt="Figure 18. Pain (on procedure, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 18</span><span class="title">Pain (on procedure, 12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig18"><div id="ch16.appe.fig18" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2019.%20Hyperthyroidism%20(symptoms%2C%2012%20months).&p=BOOKS&id=577222_ch16appef18.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef18.jpg" alt="Figure 19. Hyperthyroidism (symptoms, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 19</span><span class="title">Hyperthyroidism (symptoms, 12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig19"><div id="ch16.appe.fig19" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2020.%20Hypothyroidism%20(6%20months).&p=BOOKS&id=577222_ch16appef19.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef19.jpg" alt="Figure 20. Hypothyroidism (6 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 20</span><span class="title">Hypothyroidism (6 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig20"><div id="ch16.appe.fig20" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2021.%20RLN%20damage%20(temporary%2C%206%20months).&p=BOOKS&id=577222_ch16appef20.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef20.jpg" alt="Figure 21. RLN damage (temporary, 6 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 21</span><span class="title">RLN damage (temporary, 6 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig21"><div id="ch16.appe.fig21" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2022.%20Bleeding%20(6%20months).&p=BOOKS&id=577222_ch16appef21.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef21.jpg" alt="Figure 22. Bleeding (6 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 22</span><span class="title">Bleeding (6 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig22"><div id="ch16.appe.fig22" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2023.%20Infection%20(6%20months).&p=BOOKS&id=577222_ch16appef22.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef22.jpg" alt="Figure 23. Infection (6 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 23</span><span class="title">Infection (6 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig23"><div id="ch16.appe.fig23" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2024.%20Improvement%20in%20symptoms%20(any%20(slight%2Fmoderate%2Fsevere)%2C%206%20months).&p=BOOKS&id=577222_ch16appef23.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef23.jpg" alt="Figure 24. Improvement in symptoms (any (slight/moderate/severe), 6 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 24</span><span class="title">Improvement in symptoms (any (slight/moderate/severe), 6 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig24"><div id="ch16.appe.fig24" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2025.%20Nodule%20volume%20(%25%20reduction%2C%206%20months).&p=BOOKS&id=577222_ch16appef24.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef24.jpg" alt="Figure 25. Nodule volume (% reduction, 6 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 25</span><span class="title">Nodule volume (% reduction, 6 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig25"><div id="ch16.appe.fig25" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2026.%20Compressive%20symptoms%20(0-10%2C%20VAS%2C%20higher%20is%20worse%2C%206%20months).&p=BOOKS&id=577222_ch16appef25.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef25.jpg" alt="Figure 26. Compressive symptoms (0-10, VAS, higher is worse, 6 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 26</span><span class="title">Compressive symptoms (0-10, VAS, higher is worse, 6 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig26"><div id="ch16.appe.fig26" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2027.%20Pain%20(mild%20or%20greater%2C%20during%20procedure).&p=BOOKS&id=577222_ch16appef26.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef26.jpg" alt="Figure 27. Pain (mild or greater, during procedure)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 27</span><span class="title">Pain (mild or greater, during procedure)</span></h3></div></article><article data-type="fig" id="figobch16appefig27"><div id="ch16.appe.fig27" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2028.%20Quality%20of%20life%20(SF-36%2C%20general%20health%2C%200-100%2C%20higher%20is%20better).&p=BOOKS&id=577222_ch16appef27.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef27.jpg" alt="Figure 28. Quality of life (SF-36, general health, 0-100, higher is better)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 28</span><span class="title">Quality of life (SF-36, general health, 0-100, higher is better)</span></h3></div></article><article data-type="fig" id="figobch16appefig28"><div id="ch16.appe.fig28" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2029.%20Quality%20of%20life%20(SF-36%2C%20vitality%2C%200-100%2C%20higher%20is%20better).&p=BOOKS&id=577222_ch16appef28.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef28.jpg" alt="Figure 29. Quality of life (SF-36, vitality, 0-100, higher is better)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 29</span><span class="title">Quality of life (SF-36, vitality, 0-100, higher is better)</span></h3></div></article><article data-type="fig" id="figobch16appefig29"><div id="ch16.appe.fig29" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2030.%20Quality%20of%20life%20(SF-36%2C%20mental%20health%2C%200-100%2C%20higher%20is%20better).&p=BOOKS&id=577222_ch16appef29.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef29.jpg" alt="Figure 30. Quality of life (SF-36, mental health, 0-100, higher is better)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 30</span><span class="title">Quality of life (SF-36, mental health, 0-100, higher is better)</span></h3></div></article><article data-type="fig" id="figobch16appefig30"><div id="ch16.appe.fig30" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2031.%20Hoarseness%20(temporary%2C%2012%20months).&p=BOOKS&id=577222_ch16appef30.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef30.jpg" alt="Figure 31. Hoarseness (temporary, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 31</span><span class="title">Hoarseness (temporary, 12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig31"><div id="ch16.appe.fig31" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2032.%20Post-operative%20pain%20(temporary%2C%2012%20months).&p=BOOKS&id=577222_ch16appef31.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef31.jpg" alt="Figure 32. Post-operative pain (temporary, 12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 32</span><span class="title">Post-operative pain (temporary, 12 months)</span></h3></div></article><article data-type="fig" id="figobch16appefig32"><div id="ch16.appe.fig32" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2033.%20Resolution%20of%20compressive%20symptoms%20(12%20months).&p=BOOKS&id=577222_ch16appef32.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appef32.jpg" alt="Figure 33. Resolution of compressive symptoms (12 months)." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 33</span><span class="title">Resolution of compressive symptoms (12 months)</span></h3></div></article><article data-type="table-wrap" id="figobch16appftab1"><div id="ch16.appf.tab1" class="table"><h3><span class="label">Table 17</span><span class="title">Clinical evidence profile: T4 vs PBO/FU</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appf.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appf.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.appf.tab1_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch16.appf.tab1_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch16.appf.tab1_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch16.appf.tab1_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab1_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch16.appf.tab1_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab1_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch16.appf.tab1_1_1_1_1" id="hd_h_ch16.appf.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch16.appf.tab1_1_1_1_1" id="hd_h_ch16.appf.tab1_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch16.appf.tab1_1_1_1_1" id="hd_h_ch16.appf.tab1_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch16.appf.tab1_1_1_1_1" id="hd_h_ch16.appf.tab1_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch16.appf.tab1_1_1_1_1" id="hd_h_ch16.appf.tab1_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch16.appf.tab1_1_1_1_1" id="hd_h_ch16.appf.tab1_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch16.appf.tab1_1_1_1_1" id="hd_h_ch16.appf.tab1_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch16.appf.tab1_1_1_1_2" id="hd_h_ch16.appf.tab1_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">T4</th><th headers="hd_h_ch16.appf.tab1_1_1_1_2" id="hd_h_ch16.appf.tab1_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">PBO/FU</th><th headers="hd_h_ch16.appf.tab1_1_1_1_3" id="hd_h_ch16.appf.tab1_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch16.appf.tab1_1_1_1_3" id="hd_h_ch16.appf.tab1_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_h_ch16.appf.tab1_1_1_2_3 hd_h_ch16.appf.tab1_1_1_2_4 hd_h_ch16.appf.tab1_1_1_2_5 hd_h_ch16.appf.tab1_1_1_2_6 hd_h_ch16.appf.tab1_1_1_2_7 hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_h_ch16.appf.tab1_1_1_2_9 hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_h_ch16.appf.tab1_1_1_2_11 hd_h_ch16.appf.tab1_1_1_1_4 hd_h_ch16.appf.tab1_1_1_1_5" id="hd_b_ch16.appf.tab1_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Nodule volume (follow-up 6-60 months; measured with: ml)</th></tr><tr><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_3 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_4 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_5 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_6 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_7 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">379</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_9 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">356</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_11 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 0.79 lower (1.13 to 0.45 lower)</td><td headers="hd_h_ch16.appf.tab1_1_1_1_4 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE</p>
|
|
</td><td headers="hd_h_ch16.appf.tab1_1_1_1_5 hd_b_ch16.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_h_ch16.appf.tab1_1_1_2_3 hd_h_ch16.appf.tab1_1_1_2_4 hd_h_ch16.appf.tab1_1_1_2_5 hd_h_ch16.appf.tab1_1_1_2_6 hd_h_ch16.appf.tab1_1_1_2_7 hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_h_ch16.appf.tab1_1_1_2_9 hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_h_ch16.appf.tab1_1_1_2_11 hd_h_ch16.appf.tab1_1_1_1_4 hd_h_ch16.appf.tab1_1_1_1_5" id="hd_b_ch16.appf.tab1_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Reduction in nodule volume (follow-up 12 months; measured with: %)</th></tr><tr><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_3 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_4 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_5 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_6 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_7 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">206</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_9 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">199</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_11 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 6.9 higher (0.91 lower to 14.71 higher)</td><td headers="hd_h_ch16.appf.tab1_1_1_1_4 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_ch16.appf.tab1_1_1_1_5 hd_b_ch16.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_h_ch16.appf.tab1_1_1_2_3 hd_h_ch16.appf.tab1_1_1_2_4 hd_h_ch16.appf.tab1_1_1_2_5 hd_h_ch16.appf.tab1_1_1_2_6 hd_h_ch16.appf.tab1_1_1_2_7 hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_h_ch16.appf.tab1_1_1_2_9 hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_h_ch16.appf.tab1_1_1_2_11 hd_h_ch16.appf.tab1_1_1_1_4 hd_h_ch16.appf.tab1_1_1_1_5" id="hd_b_ch16.appf.tab1_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Thyroid volume (follow-up 12 months; measured with: ml)</th></tr><tr><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_3 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_4 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_5 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_6 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_7 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">36</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_9 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">35</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_11 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 9.4 lower (14.53 to 4.27 lower)</td><td headers="hd_h_ch16.appf.tab1_1_1_1_4 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE</p>
|
|
</td><td headers="hd_h_ch16.appf.tab1_1_1_1_5 hd_b_ch16.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_h_ch16.appf.tab1_1_1_2_3 hd_h_ch16.appf.tab1_1_1_2_4 hd_h_ch16.appf.tab1_1_1_2_5 hd_h_ch16.appf.tab1_1_1_2_6 hd_h_ch16.appf.tab1_1_1_2_7 hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_h_ch16.appf.tab1_1_1_2_9 hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_h_ch16.appf.tab1_1_1_2_11 hd_h_ch16.appf.tab1_1_1_1_4 hd_h_ch16.appf.tab1_1_1_1_5" id="hd_b_ch16.appf.tab1_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Hyperthyroidism (follow-up 18 months; assessed with: ‘Severe’ (nil else specified))</th></tr><tr><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_3 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_4 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_5 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_6 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_7 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>1/64</p>
|
|
<p>(1.6%)</p>
|
|
</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_9 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1.7%</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.92 (0.06 to 14.41)</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_11 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1 fewer per 1000 (from 16 fewer to 228 more)</td><td headers="hd_h_ch16.appf.tab1_1_1_1_4 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch16.appf.tab1_1_1_1_5 hd_b_ch16.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_h_ch16.appf.tab1_1_1_2_3 hd_h_ch16.appf.tab1_1_1_2_4 hd_h_ch16.appf.tab1_1_1_2_5 hd_h_ch16.appf.tab1_1_1_2_6 hd_h_ch16.appf.tab1_1_1_2_7 hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_h_ch16.appf.tab1_1_1_2_9 hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_h_ch16.appf.tab1_1_1_2_11 hd_h_ch16.appf.tab1_1_1_1_4 hd_h_ch16.appf.tab1_1_1_1_5" id="hd_b_ch16.appf.tab1_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Improvement in symptoms (follow-up 12 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_3 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_4 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_5 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_6 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_7 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>2/15</p>
|
|
<p>(13.3%)</p>
|
|
</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_9 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0%</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Peto OR 7.43 (0.44 to 125.12)</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_11 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">130 more per 1000 (from 70 fewer to 330 more)<sup>3</sup></td><td headers="hd_h_ch16.appf.tab1_1_1_1_4 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch16.appf.tab1_1_1_1_5 hd_b_ch16.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_h_ch16.appf.tab1_1_1_2_3 hd_h_ch16.appf.tab1_1_1_2_4 hd_h_ch16.appf.tab1_1_1_2_5 hd_h_ch16.appf.tab1_1_1_2_6 hd_h_ch16.appf.tab1_1_1_2_7 hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_h_ch16.appf.tab1_1_1_2_9 hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_h_ch16.appf.tab1_1_1_2_11 hd_h_ch16.appf.tab1_1_1_1_4 hd_h_ch16.appf.tab1_1_1_1_5" id="hd_b_ch16.appf.tab1_1_1_11_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Arrhythmias (follow-up 12 months; assessed with: Reported as AF)</th></tr><tr><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_1 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_2 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_3 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_4 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_5 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_6 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab1_1_1_1_1 hd_h_ch16.appf.tab1_1_1_2_7 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_8 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>0/206</p>
|
|
<p>(0%)</p>
|
|
</td><td headers="hd_h_ch16.appf.tab1_1_1_1_2 hd_h_ch16.appf.tab1_1_1_2_9 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1%</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_10 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Peto OR 0.13 (0.01 to 2.09)</td><td headers="hd_h_ch16.appf.tab1_1_1_1_3 hd_h_ch16.appf.tab1_1_1_2_11 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">9 fewer per 1000 (from 10 fewer to 11 more)</td><td headers="hd_h_ch16.appf.tab1_1_1_1_4 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab1_1_1_1_5 hd_b_ch16.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.appf.tab1_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.appf.tab1_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.appf.tab1_3"><p class="no_margin">Zero events in control arm</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16appftab2"><div id="ch16.appf.tab2" class="table"><h3><span class="label">Table 18</span><span class="title">Clinical evidence profile: RFA vs FU</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appf.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appf.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.appf.tab2_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch16.appf.tab2_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch16.appf.tab2_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch16.appf.tab2_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab2_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch16.appf.tab2_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab2_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch16.appf.tab2_1_1_1_1" id="hd_h_ch16.appf.tab2_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch16.appf.tab2_1_1_1_1" id="hd_h_ch16.appf.tab2_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch16.appf.tab2_1_1_1_1" id="hd_h_ch16.appf.tab2_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch16.appf.tab2_1_1_1_1" id="hd_h_ch16.appf.tab2_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch16.appf.tab2_1_1_1_1" id="hd_h_ch16.appf.tab2_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch16.appf.tab2_1_1_1_1" id="hd_h_ch16.appf.tab2_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch16.appf.tab2_1_1_1_1" id="hd_h_ch16.appf.tab2_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch16.appf.tab2_1_1_1_2" id="hd_h_ch16.appf.tab2_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">RFA</th><th headers="hd_h_ch16.appf.tab2_1_1_1_2" id="hd_h_ch16.appf.tab2_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Follow-up only</th><th headers="hd_h_ch16.appf.tab2_1_1_1_3" id="hd_h_ch16.appf.tab2_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch16.appf.tab2_1_1_1_3" id="hd_h_ch16.appf.tab2_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_1 hd_h_ch16.appf.tab2_1_1_2_2 hd_h_ch16.appf.tab2_1_1_2_3 hd_h_ch16.appf.tab2_1_1_2_4 hd_h_ch16.appf.tab2_1_1_2_5 hd_h_ch16.appf.tab2_1_1_2_6 hd_h_ch16.appf.tab2_1_1_2_7 hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_8 hd_h_ch16.appf.tab2_1_1_2_9 hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_10 hd_h_ch16.appf.tab2_1_1_2_11 hd_h_ch16.appf.tab2_1_1_1_4 hd_h_ch16.appf.tab2_1_1_1_5" id="hd_b_ch16.appf.tab2_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Nodule volume (follow-up 6 months; measured with: ml)</th></tr><tr><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_1 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_2 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_3 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_4 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_5 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_6 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_7 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_8 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">82</td><td headers="hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_9 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">82</td><td headers="hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_10 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_11 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 10.8 lower (12.14 to 9.45 lower)</td><td headers="hd_h_ch16.appf.tab2_1_1_1_4 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁⨁⨁</p>
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<p>HIGH</p>
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</td><td headers="hd_h_ch16.appf.tab2_1_1_1_5 hd_b_ch16.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_1 hd_h_ch16.appf.tab2_1_1_2_2 hd_h_ch16.appf.tab2_1_1_2_3 hd_h_ch16.appf.tab2_1_1_2_4 hd_h_ch16.appf.tab2_1_1_2_5 hd_h_ch16.appf.tab2_1_1_2_6 hd_h_ch16.appf.tab2_1_1_2_7 hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_8 hd_h_ch16.appf.tab2_1_1_2_9 hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_10 hd_h_ch16.appf.tab2_1_1_2_11 hd_h_ch16.appf.tab2_1_1_1_4 hd_h_ch16.appf.tab2_1_1_1_5" id="hd_b_ch16.appf.tab2_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Hypothyroidism (follow-up 6 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_1 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_2 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_3 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_4 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_5 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_6 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_7 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_8 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>0/42</p>
|
|
<p>(0%)</p>
|
|
</td><td headers="hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_9 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>0/42</p>
|
|
<p>(0%)</p>
|
|
</td><td headers="hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_10 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-<sup>3</sup></td><td headers="hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_11 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">not estimable</td><td headers="hd_h_ch16.appf.tab2_1_1_1_4 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab2_1_1_1_5 hd_b_ch16.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_1 hd_h_ch16.appf.tab2_1_1_2_2 hd_h_ch16.appf.tab2_1_1_2_3 hd_h_ch16.appf.tab2_1_1_2_4 hd_h_ch16.appf.tab2_1_1_2_5 hd_h_ch16.appf.tab2_1_1_2_6 hd_h_ch16.appf.tab2_1_1_2_7 hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_8 hd_h_ch16.appf.tab2_1_1_2_9 hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_10 hd_h_ch16.appf.tab2_1_1_2_11 hd_h_ch16.appf.tab2_1_1_1_4 hd_h_ch16.appf.tab2_1_1_1_5" id="hd_b_ch16.appf.tab2_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Hyperthyroidism (follow-up 6 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_1 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_2 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_3 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_4 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_5 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_6 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_7 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_8 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>1/42</p>
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<p>(2.4%)</p>
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</td><td headers="hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_9 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0%</td><td headers="hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_10 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Peto OR 7.39 (0.15 to 372.38)</td><td headers="hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_11 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>23 more per 1000</p>
|
|
<p>(from 40 fewer to 90 more)<sup>4</sup></p>
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</td><td headers="hd_h_ch16.appf.tab2_1_1_1_4 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab2_1_1_1_5 hd_b_ch16.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_1 hd_h_ch16.appf.tab2_1_1_2_2 hd_h_ch16.appf.tab2_1_1_2_3 hd_h_ch16.appf.tab2_1_1_2_4 hd_h_ch16.appf.tab2_1_1_2_5 hd_h_ch16.appf.tab2_1_1_2_6 hd_h_ch16.appf.tab2_1_1_2_7 hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_8 hd_h_ch16.appf.tab2_1_1_2_9 hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_10 hd_h_ch16.appf.tab2_1_1_2_11 hd_h_ch16.appf.tab2_1_1_1_4 hd_h_ch16.appf.tab2_1_1_1_5" id="hd_b_ch16.appf.tab2_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Compressive symptoms (follow-up 6 months; measured with: VAS (0-10, higher is worse))</th></tr><tr><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_1 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_2 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_3 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_4 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_5 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_6 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab2_1_1_1_1 hd_h_ch16.appf.tab2_1_1_2_7 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_8 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">82</td><td headers="hd_h_ch16.appf.tab2_1_1_1_2 hd_h_ch16.appf.tab2_1_1_2_9 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">82</td><td headers="hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_10 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab2_1_1_1_3 hd_h_ch16.appf.tab2_1_1_2_11 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 2.8 lower (3.3 to 2.31 lower)</td><td headers="hd_h_ch16.appf.tab2_1_1_1_4 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁⨁◯</p>
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<p>MODERATE</p>
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</td><td headers="hd_h_ch16.appf.tab2_1_1_1_5 hd_b_ch16.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.appf.tab2_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.appf.tab2_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.appf.tab2_3"><p class="no_margin">Zero events in either arm</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="ch16.appf.tab2_4"><p class="no_margin">Zero events in control arm</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16appftab3"><div id="ch16.appf.tab3" class="table"><h3><span class="label">Table 19</span><span class="title">Clinical evidence profile: LA vs FU</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appf.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appf.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.appf.tab3_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch16.appf.tab3_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch16.appf.tab3_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch16.appf.tab3_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab3_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch16.appf.tab3_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab3_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch16.appf.tab3_1_1_1_1" id="hd_h_ch16.appf.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch16.appf.tab3_1_1_1_1" id="hd_h_ch16.appf.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch16.appf.tab3_1_1_1_1" id="hd_h_ch16.appf.tab3_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch16.appf.tab3_1_1_1_1" id="hd_h_ch16.appf.tab3_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch16.appf.tab3_1_1_1_1" id="hd_h_ch16.appf.tab3_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch16.appf.tab3_1_1_1_1" id="hd_h_ch16.appf.tab3_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch16.appf.tab3_1_1_1_1" id="hd_h_ch16.appf.tab3_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch16.appf.tab3_1_1_1_2" id="hd_h_ch16.appf.tab3_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">LA</th><th headers="hd_h_ch16.appf.tab3_1_1_1_2" id="hd_h_ch16.appf.tab3_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Follow-up only</th><th headers="hd_h_ch16.appf.tab3_1_1_1_3" id="hd_h_ch16.appf.tab3_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch16.appf.tab3_1_1_1_3" id="hd_h_ch16.appf.tab3_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_1 hd_h_ch16.appf.tab3_1_1_2_2 hd_h_ch16.appf.tab3_1_1_2_3 hd_h_ch16.appf.tab3_1_1_2_4 hd_h_ch16.appf.tab3_1_1_2_5 hd_h_ch16.appf.tab3_1_1_2_6 hd_h_ch16.appf.tab3_1_1_2_7 hd_h_ch16.appf.tab3_1_1_1_2 hd_h_ch16.appf.tab3_1_1_2_8 hd_h_ch16.appf.tab3_1_1_2_9 hd_h_ch16.appf.tab3_1_1_1_3 hd_h_ch16.appf.tab3_1_1_2_10 hd_h_ch16.appf.tab3_1_1_2_11 hd_h_ch16.appf.tab3_1_1_1_4 hd_h_ch16.appf.tab3_1_1_1_5" id="hd_b_ch16.appf.tab3_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Change in nodule volume (follow-up 12 months; measured with: ml; Better indicated by lower values)</th></tr><tr><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_1 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_2 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_3 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_4 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_5 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_6 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_7 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab3_1_1_1_2 hd_h_ch16.appf.tab3_1_1_2_8 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">21</td><td headers="hd_h_ch16.appf.tab3_1_1_1_2 hd_h_ch16.appf.tab3_1_1_2_9 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">20</td><td headers="hd_h_ch16.appf.tab3_1_1_1_3 hd_h_ch16.appf.tab3_1_1_2_10 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab3_1_1_1_3 hd_h_ch16.appf.tab3_1_1_2_11 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 5.9 lower (7.54 to 4.26 lower)</td><td headers="hd_h_ch16.appf.tab3_1_1_1_4 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁⨁◯</p>
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<p>MODERATE</p>
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</td><td headers="hd_h_ch16.appf.tab3_1_1_1_5 hd_b_ch16.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_1 hd_h_ch16.appf.tab3_1_1_2_2 hd_h_ch16.appf.tab3_1_1_2_3 hd_h_ch16.appf.tab3_1_1_2_4 hd_h_ch16.appf.tab3_1_1_2_5 hd_h_ch16.appf.tab3_1_1_2_6 hd_h_ch16.appf.tab3_1_1_2_7 hd_h_ch16.appf.tab3_1_1_1_2 hd_h_ch16.appf.tab3_1_1_2_8 hd_h_ch16.appf.tab3_1_1_2_9 hd_h_ch16.appf.tab3_1_1_1_3 hd_h_ch16.appf.tab3_1_1_2_10 hd_h_ch16.appf.tab3_1_1_2_11 hd_h_ch16.appf.tab3_1_1_1_4 hd_h_ch16.appf.tab3_1_1_1_5" id="hd_b_ch16.appf.tab3_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Improvement in symptoms (follow-up 12 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_1 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_2 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_3 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_4 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_5 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_6 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab3_1_1_1_1 hd_h_ch16.appf.tab3_1_1_2_7 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab3_1_1_1_2 hd_h_ch16.appf.tab3_1_1_2_8 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab3_1_1_1_2 hd_h_ch16.appf.tab3_1_1_2_9 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0%</td><td headers="hd_h_ch16.appf.tab3_1_1_1_3 hd_h_ch16.appf.tab3_1_1_2_10 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Peto OR 24.5 (5.9 to 101.6)</td><td headers="hd_h_ch16.appf.tab3_1_1_1_3 hd_h_ch16.appf.tab3_1_1_2_11 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">810 more per 1000 (from 60 more to 1000 more)<sup>3</sup></td><td headers="hd_h_ch16.appf.tab3_1_1_1_4 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab3_1_1_1_5 hd_b_ch16.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.appf.tab3_1"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.appf.tab3_2"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.appf.tab3_3"><p class="no_margin">Zero events in control arm</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16appftab4"><div id="ch16.appf.tab4" class="table"><h3><span class="label">Table 20</span><span class="title">Clinical evidence profile: LA vs T4</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appf.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appf.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.appf.tab4_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch16.appf.tab4_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch16.appf.tab4_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch16.appf.tab4_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab4_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch16.appf.tab4_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab4_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch16.appf.tab4_1_1_1_1" id="hd_h_ch16.appf.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch16.appf.tab4_1_1_1_1" id="hd_h_ch16.appf.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch16.appf.tab4_1_1_1_1" id="hd_h_ch16.appf.tab4_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch16.appf.tab4_1_1_1_1" id="hd_h_ch16.appf.tab4_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch16.appf.tab4_1_1_1_1" id="hd_h_ch16.appf.tab4_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch16.appf.tab4_1_1_1_1" id="hd_h_ch16.appf.tab4_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch16.appf.tab4_1_1_1_1" id="hd_h_ch16.appf.tab4_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch16.appf.tab4_1_1_1_2" id="hd_h_ch16.appf.tab4_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">LA</th><th headers="hd_h_ch16.appf.tab4_1_1_1_2" id="hd_h_ch16.appf.tab4_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">T4</th><th headers="hd_h_ch16.appf.tab4_1_1_1_3" id="hd_h_ch16.appf.tab4_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch16.appf.tab4_1_1_1_3" id="hd_h_ch16.appf.tab4_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_1 hd_h_ch16.appf.tab4_1_1_2_2 hd_h_ch16.appf.tab4_1_1_2_3 hd_h_ch16.appf.tab4_1_1_2_4 hd_h_ch16.appf.tab4_1_1_2_5 hd_h_ch16.appf.tab4_1_1_2_6 hd_h_ch16.appf.tab4_1_1_2_7 hd_h_ch16.appf.tab4_1_1_1_2 hd_h_ch16.appf.tab4_1_1_2_8 hd_h_ch16.appf.tab4_1_1_2_9 hd_h_ch16.appf.tab4_1_1_1_3 hd_h_ch16.appf.tab4_1_1_2_10 hd_h_ch16.appf.tab4_1_1_2_11 hd_h_ch16.appf.tab4_1_1_1_4 hd_h_ch16.appf.tab4_1_1_1_5" id="hd_b_ch16.appf.tab4_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Change in nodule volume (follow-up 12 months; measured with: ml; Better indicated by lower values)</th></tr><tr><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_1 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_2 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_3 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_4 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_5 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_6 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_7 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab4_1_1_1_2 hd_h_ch16.appf.tab4_1_1_2_8 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">21</td><td headers="hd_h_ch16.appf.tab4_1_1_1_2 hd_h_ch16.appf.tab4_1_1_2_9 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">21</td><td headers="hd_h_ch16.appf.tab4_1_1_1_3 hd_h_ch16.appf.tab4_1_1_2_10 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab4_1_1_1_3 hd_h_ch16.appf.tab4_1_1_2_11 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 4.6 lower (6.25 to 2.95 lower)</td><td headers="hd_h_ch16.appf.tab4_1_1_1_4 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁⨁◯</p>
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<p>MODERATE</p>
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</td><td headers="hd_h_ch16.appf.tab4_1_1_1_5 hd_b_ch16.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_1 hd_h_ch16.appf.tab4_1_1_2_2 hd_h_ch16.appf.tab4_1_1_2_3 hd_h_ch16.appf.tab4_1_1_2_4 hd_h_ch16.appf.tab4_1_1_2_5 hd_h_ch16.appf.tab4_1_1_2_6 hd_h_ch16.appf.tab4_1_1_2_7 hd_h_ch16.appf.tab4_1_1_1_2 hd_h_ch16.appf.tab4_1_1_2_8 hd_h_ch16.appf.tab4_1_1_2_9 hd_h_ch16.appf.tab4_1_1_1_3 hd_h_ch16.appf.tab4_1_1_2_10 hd_h_ch16.appf.tab4_1_1_2_11 hd_h_ch16.appf.tab4_1_1_1_4 hd_h_ch16.appf.tab4_1_1_1_5" id="hd_b_ch16.appf.tab4_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Improvement in symptoms (follow-up 12 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_1 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_2 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_3 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_4 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_5 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_6 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab4_1_1_1_1 hd_h_ch16.appf.tab4_1_1_2_7 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab4_1_1_1_2 hd_h_ch16.appf.tab4_1_1_2_8 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab4_1_1_1_2 hd_h_ch16.appf.tab4_1_1_2_9 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">13.3%</td><td headers="hd_h_ch16.appf.tab4_1_1_1_3 hd_h_ch16.appf.tab4_1_1_2_10 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 6.09 (1.64 to 22.62)</td><td headers="hd_h_ch16.appf.tab4_1_1_1_3 hd_h_ch16.appf.tab4_1_1_2_11 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">677 more per 1000 (from 85 more to 1000 more)</td><td headers="hd_h_ch16.appf.tab4_1_1_1_4 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>LOW</p>
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</td><td headers="hd_h_ch16.appf.tab4_1_1_1_5 hd_b_ch16.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.appf.tab4_1"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.appf.tab4_2"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16appftab5"><div id="ch16.appf.tab5" class="table"><h3><span class="label">Table 21</span><span class="title">Clinical evidence profile: PEI vs T4</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appf.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appf.tab5_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.appf.tab5_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch16.appf.tab5_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch16.appf.tab5_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch16.appf.tab5_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab5_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch16.appf.tab5_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab5_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch16.appf.tab5_1_1_1_1" id="hd_h_ch16.appf.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch16.appf.tab5_1_1_1_1" id="hd_h_ch16.appf.tab5_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch16.appf.tab5_1_1_1_1" id="hd_h_ch16.appf.tab5_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch16.appf.tab5_1_1_1_1" id="hd_h_ch16.appf.tab5_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch16.appf.tab5_1_1_1_1" id="hd_h_ch16.appf.tab5_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch16.appf.tab5_1_1_1_1" id="hd_h_ch16.appf.tab5_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch16.appf.tab5_1_1_1_1" id="hd_h_ch16.appf.tab5_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch16.appf.tab5_1_1_1_2" id="hd_h_ch16.appf.tab5_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">PEI</th><th headers="hd_h_ch16.appf.tab5_1_1_1_2" id="hd_h_ch16.appf.tab5_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">T4</th><th headers="hd_h_ch16.appf.tab5_1_1_1_3" id="hd_h_ch16.appf.tab5_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch16.appf.tab5_1_1_1_3" id="hd_h_ch16.appf.tab5_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_1 hd_h_ch16.appf.tab5_1_1_2_2 hd_h_ch16.appf.tab5_1_1_2_3 hd_h_ch16.appf.tab5_1_1_2_4 hd_h_ch16.appf.tab5_1_1_2_5 hd_h_ch16.appf.tab5_1_1_2_6 hd_h_ch16.appf.tab5_1_1_2_7 hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_8 hd_h_ch16.appf.tab5_1_1_2_9 hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_10 hd_h_ch16.appf.tab5_1_1_2_11 hd_h_ch16.appf.tab5_1_1_1_4 hd_h_ch16.appf.tab5_1_1_1_5" id="hd_b_ch16.appf.tab5_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Reduction in nodule volume (follow-up 12 months; measured with: % changes)</th></tr><tr><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_1 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_2 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_3 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_4 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_5 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_6 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_7 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_8 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">25</td><td headers="hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_9 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">25</td><td headers="hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_10 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_11 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 38 higher (19.08 to 56.92 higher)</td><td headers="hd_h_ch16.appf.tab5_1_1_1_4 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>LOW</p>
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</td><td headers="hd_h_ch16.appf.tab5_1_1_1_5 hd_b_ch16.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_1 hd_h_ch16.appf.tab5_1_1_2_2 hd_h_ch16.appf.tab5_1_1_2_3 hd_h_ch16.appf.tab5_1_1_2_4 hd_h_ch16.appf.tab5_1_1_2_5 hd_h_ch16.appf.tab5_1_1_2_6 hd_h_ch16.appf.tab5_1_1_2_7 hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_8 hd_h_ch16.appf.tab5_1_1_2_9 hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_10 hd_h_ch16.appf.tab5_1_1_2_11 hd_h_ch16.appf.tab5_1_1_1_4 hd_h_ch16.appf.tab5_1_1_1_5" id="hd_b_ch16.appf.tab5_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Compressive symptoms (follow-up 12 months; assessed with: Any improvement)</th></tr><tr><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_1 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_2 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_3 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_4 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_5 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_6 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_7 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_8 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>17/22</p>
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<p>(77.3%)</p>
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</td><td headers="hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_9 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">50%</td><td headers="hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_10 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 1.55 (0.96 to 2.49)</td><td headers="hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_11 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">275 more per 1000 (from 20 fewer to 745 more)</td><td headers="hd_h_ch16.appf.tab5_1_1_1_4 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>LOW</p>
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</td><td headers="hd_h_ch16.appf.tab5_1_1_1_5 hd_b_ch16.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_1 hd_h_ch16.appf.tab5_1_1_2_2 hd_h_ch16.appf.tab5_1_1_2_3 hd_h_ch16.appf.tab5_1_1_2_4 hd_h_ch16.appf.tab5_1_1_2_5 hd_h_ch16.appf.tab5_1_1_2_6 hd_h_ch16.appf.tab5_1_1_2_7 hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_8 hd_h_ch16.appf.tab5_1_1_2_9 hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_10 hd_h_ch16.appf.tab5_1_1_2_11 hd_h_ch16.appf.tab5_1_1_1_4 hd_h_ch16.appf.tab5_1_1_1_5" id="hd_b_ch16.appf.tab5_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Pain (follow-up 12 months; assessed with: On procedure)</th></tr><tr><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_1 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_2 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_3 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_4 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_5 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_6 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_7 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_8 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>24/25</p>
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<p>(96%)</p>
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</td><td headers="hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_9 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0%</td><td headers="hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_10 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Peto OR 43.35 (14.45 to 130.02)</td><td headers="hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_11 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">960 more per 1000 (from 860 more to 1000 more)<sup>3</sup></td><td headers="hd_h_ch16.appf.tab5_1_1_1_4 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁⨁◯</p>
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<p>MODERATE</p>
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</td><td headers="hd_h_ch16.appf.tab5_1_1_1_5 hd_b_ch16.appf.tab5_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_1 hd_h_ch16.appf.tab5_1_1_2_2 hd_h_ch16.appf.tab5_1_1_2_3 hd_h_ch16.appf.tab5_1_1_2_4 hd_h_ch16.appf.tab5_1_1_2_5 hd_h_ch16.appf.tab5_1_1_2_6 hd_h_ch16.appf.tab5_1_1_2_7 hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_8 hd_h_ch16.appf.tab5_1_1_2_9 hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_10 hd_h_ch16.appf.tab5_1_1_2_11 hd_h_ch16.appf.tab5_1_1_1_4 hd_h_ch16.appf.tab5_1_1_1_5" id="hd_b_ch16.appf.tab5_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Hyperthyroidism (follow-up 12 months; assessed with: Presence of symptoms and TSH changes)</th></tr><tr><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_1 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_2 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_3 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_4 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_5 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_6 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab5_1_1_1_1 hd_h_ch16.appf.tab5_1_1_2_7 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_8 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>0/25</p>
|
|
<p>(0%)</p>
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|
</td><td headers="hd_h_ch16.appf.tab5_1_1_1_2 hd_h_ch16.appf.tab5_1_1_2_9 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">20%</td><td headers="hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_10 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Peto OR 0.11 (0.2 to 0.71)</td><td headers="hd_h_ch16.appf.tab5_1_1_1_3 hd_h_ch16.appf.tab5_1_1_2_11 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">173 fewer per 1000 (from 49 fewer to 152 fewer)</td><td headers="hd_h_ch16.appf.tab5_1_1_1_4 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW</p>
|
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</td><td headers="hd_h_ch16.appf.tab5_1_1_1_5 hd_b_ch16.appf.tab5_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.appf.tab5_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.appf.tab5_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.appf.tab5_3"><p class="no_margin">Zero events in control arm</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16appftab6"><div id="ch16.appf.tab6" class="table"><h3><span class="label">Table 22</span><span class="title">Clinical evidence profile: HIFU vs surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appf.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appf.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.appf.tab6_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch16.appf.tab6_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch16.appf.tab6_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch16.appf.tab6_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab6_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch16.appf.tab6_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab6_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch16.appf.tab6_1_1_1_1" id="hd_h_ch16.appf.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch16.appf.tab6_1_1_1_1" id="hd_h_ch16.appf.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch16.appf.tab6_1_1_1_1" id="hd_h_ch16.appf.tab6_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch16.appf.tab6_1_1_1_1" id="hd_h_ch16.appf.tab6_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch16.appf.tab6_1_1_1_1" id="hd_h_ch16.appf.tab6_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch16.appf.tab6_1_1_1_1" id="hd_h_ch16.appf.tab6_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch16.appf.tab6_1_1_1_1" id="hd_h_ch16.appf.tab6_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch16.appf.tab6_1_1_1_2" id="hd_h_ch16.appf.tab6_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">HIFU</th><th headers="hd_h_ch16.appf.tab6_1_1_1_2" id="hd_h_ch16.appf.tab6_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Surgery</th><th headers="hd_h_ch16.appf.tab6_1_1_1_3" id="hd_h_ch16.appf.tab6_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch16.appf.tab6_1_1_1_3" id="hd_h_ch16.appf.tab6_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_h_ch16.appf.tab6_1_1_2_3 hd_h_ch16.appf.tab6_1_1_2_4 hd_h_ch16.appf.tab6_1_1_2_5 hd_h_ch16.appf.tab6_1_1_2_6 hd_h_ch16.appf.tab6_1_1_2_7 hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_h_ch16.appf.tab6_1_1_2_9 hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_h_ch16.appf.tab6_1_1_2_11 hd_h_ch16.appf.tab6_1_1_1_4 hd_h_ch16.appf.tab6_1_1_1_5" id="hd_b_ch16.appf.tab6_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Nodule volume (% reduction) (follow-up 6 months; Better indicated by lower values)</th></tr><tr><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_3 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias<sup>1</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_4 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_5 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_6 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_7 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">77</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_9 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">77</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_11 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 36 higher<sup>2</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_4 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>LOW</p>
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</td><td headers="hd_h_ch16.appf.tab6_1_1_1_5 hd_b_ch16.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_h_ch16.appf.tab6_1_1_2_3 hd_h_ch16.appf.tab6_1_1_2_4 hd_h_ch16.appf.tab6_1_1_2_5 hd_h_ch16.appf.tab6_1_1_2_6 hd_h_ch16.appf.tab6_1_1_2_7 hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_h_ch16.appf.tab6_1_1_2_9 hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_h_ch16.appf.tab6_1_1_2_11 hd_h_ch16.appf.tab6_1_1_1_4 hd_h_ch16.appf.tab6_1_1_1_5" id="hd_b_ch16.appf.tab6_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Hypothyroidism (follow-up 6 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_3 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias<sup>1</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_4 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_5 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_6 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_7 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>0/77</p>
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<p>(0%)</p>
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</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_9 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">5.2%</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Peto OR 0.13 (0.02 to 0.94)</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_11 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">45 fewer per 1000 (from 3 fewer to 51 fewer)</td><td headers="hd_h_ch16.appf.tab6_1_1_1_4 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab6_1_1_1_5 hd_b_ch16.appf.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_h_ch16.appf.tab6_1_1_2_3 hd_h_ch16.appf.tab6_1_1_2_4 hd_h_ch16.appf.tab6_1_1_2_5 hd_h_ch16.appf.tab6_1_1_2_6 hd_h_ch16.appf.tab6_1_1_2_7 hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_h_ch16.appf.tab6_1_1_2_9 hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_h_ch16.appf.tab6_1_1_2_11 hd_h_ch16.appf.tab6_1_1_1_4 hd_h_ch16.appf.tab6_1_1_1_5" id="hd_b_ch16.appf.tab6_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">RLN palsy (temporary) (follow-up 6 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_3 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias<sup>1</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_4 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_5 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_6 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>3</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_7 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>3/77</p>
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<p>(3.9%)</p>
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</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_9 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">3.9%</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 1 (0.21 to 4.8)</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_11 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0 fewer per 1000 (from 31 fewer to 148 more)</td><td headers="hd_h_ch16.appf.tab6_1_1_1_4 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab6_1_1_1_5 hd_b_ch16.appf.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_h_ch16.appf.tab6_1_1_2_3 hd_h_ch16.appf.tab6_1_1_2_4 hd_h_ch16.appf.tab6_1_1_2_5 hd_h_ch16.appf.tab6_1_1_2_6 hd_h_ch16.appf.tab6_1_1_2_7 hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_h_ch16.appf.tab6_1_1_2_9 hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_h_ch16.appf.tab6_1_1_2_11 hd_h_ch16.appf.tab6_1_1_1_4 hd_h_ch16.appf.tab6_1_1_1_5" id="hd_b_ch16.appf.tab6_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Bleeding (requiring re-exploration) (follow-up 6 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_3 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias<sup>1</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_4 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_5 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_6 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>3</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_7 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>0/77</p>
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<p>(0%)</p>
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</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_9 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1.30%</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Peto OR 0.14 (0 to 6.82)</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_11 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">11 fewer per 1000 (from 13 fewer to 69 more)</td><td headers="hd_h_ch16.appf.tab6_1_1_1_4 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab6_1_1_1_5 hd_b_ch16.appf.tab6_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_h_ch16.appf.tab6_1_1_2_3 hd_h_ch16.appf.tab6_1_1_2_4 hd_h_ch16.appf.tab6_1_1_2_5 hd_h_ch16.appf.tab6_1_1_2_6 hd_h_ch16.appf.tab6_1_1_2_7 hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_h_ch16.appf.tab6_1_1_2_9 hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_h_ch16.appf.tab6_1_1_2_11 hd_h_ch16.appf.tab6_1_1_1_4 hd_h_ch16.appf.tab6_1_1_1_5" id="hd_b_ch16.appf.tab6_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Infection (follow-up 6 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_3 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_4 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_5 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_6 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>4</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_7 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>0/77</p>
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<p>(0%)</p>
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</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_9 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0%</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_11 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">not estimable</td><td headers="hd_h_ch16.appf.tab6_1_1_1_4 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab6_1_1_1_5 hd_b_ch16.appf.tab6_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_h_ch16.appf.tab6_1_1_2_3 hd_h_ch16.appf.tab6_1_1_2_4 hd_h_ch16.appf.tab6_1_1_2_5 hd_h_ch16.appf.tab6_1_1_2_6 hd_h_ch16.appf.tab6_1_1_2_7 hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_h_ch16.appf.tab6_1_1_2_9 hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_h_ch16.appf.tab6_1_1_2_11 hd_h_ch16.appf.tab6_1_1_1_4 hd_h_ch16.appf.tab6_1_1_1_5" id="hd_b_ch16.appf.tab6_1_1_11_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Improvement in symptoms (follow-up 6 months; assessed with: (any increase (slight/moderate/significant))</th></tr><tr><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_1 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_2 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_3 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>5</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_4 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_5 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_6 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch16.appf.tab6_1_1_1_1 hd_h_ch16.appf.tab6_1_1_2_7 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_8 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>73/77</p>
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<p>(94.8%)</p>
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</td><td headers="hd_h_ch16.appf.tab6_1_1_1_2 hd_h_ch16.appf.tab6_1_1_2_9 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">87%</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_10 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 1.09 (0.98 to 1.21)</td><td headers="hd_h_ch16.appf.tab6_1_1_1_3 hd_h_ch16.appf.tab6_1_1_2_11 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">78 more per 1000 (from 17 fewer to 183 more)</td><td headers="hd_h_ch16.appf.tab6_1_1_1_4 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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|
</td><td headers="hd_h_ch16.appf.tab6_1_1_1_5 hd_b_ch16.appf.tab6_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.appf.tab6_1"><p class="no_margin">No additional risk of bias beyond default selection bias for non-randomised studies</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.appf.tab6_2"><p class="no_margin">95% confidence intervals cannot be calculated as no SD available for surgery (all participants with whole nodule removed), therefore there is no forest plot displayed in the appendix.</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.appf.tab6_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="ch16.appf.tab6_4"><p class="no_margin">Zero events in either arm</p></div></dd></dl><dl class="bkr_refwrap"><dt>5</dt><dd><div id="ch16.appf.tab6_5"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16appftab7"><div id="ch16.appf.tab7" class="table"><h3><span class="label">Table 23</span><span class="title">Clinical evidence profile: RFA vs PEI</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appf.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appf.tab7_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.appf.tab7_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch16.appf.tab7_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch16.appf.tab7_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch16.appf.tab7_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab7_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch16.appf.tab7_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab7_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch16.appf.tab7_1_1_1_1" id="hd_h_ch16.appf.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch16.appf.tab7_1_1_1_1" id="hd_h_ch16.appf.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch16.appf.tab7_1_1_1_1" id="hd_h_ch16.appf.tab7_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch16.appf.tab7_1_1_1_1" id="hd_h_ch16.appf.tab7_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch16.appf.tab7_1_1_1_1" id="hd_h_ch16.appf.tab7_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch16.appf.tab7_1_1_1_1" id="hd_h_ch16.appf.tab7_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch16.appf.tab7_1_1_1_1" id="hd_h_ch16.appf.tab7_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch16.appf.tab7_1_1_1_2" id="hd_h_ch16.appf.tab7_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">RFA</th><th headers="hd_h_ch16.appf.tab7_1_1_1_2" id="hd_h_ch16.appf.tab7_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">PEI</th><th headers="hd_h_ch16.appf.tab7_1_1_1_3" id="hd_h_ch16.appf.tab7_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch16.appf.tab7_1_1_1_3" id="hd_h_ch16.appf.tab7_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_1 hd_h_ch16.appf.tab7_1_1_2_2 hd_h_ch16.appf.tab7_1_1_2_3 hd_h_ch16.appf.tab7_1_1_2_4 hd_h_ch16.appf.tab7_1_1_2_5 hd_h_ch16.appf.tab7_1_1_2_6 hd_h_ch16.appf.tab7_1_1_2_7 hd_h_ch16.appf.tab7_1_1_1_2 hd_h_ch16.appf.tab7_1_1_2_8 hd_h_ch16.appf.tab7_1_1_2_9 hd_h_ch16.appf.tab7_1_1_1_3 hd_h_ch16.appf.tab7_1_1_2_10 hd_h_ch16.appf.tab7_1_1_2_11 hd_h_ch16.appf.tab7_1_1_1_4 hd_h_ch16.appf.tab7_1_1_1_5" id="hd_b_ch16.appf.tab7_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Nodule volume (follow-up 6 months; measured with: % reduction)</th></tr><tr><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_1 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_2 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_3 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_4 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_5 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_6 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_7 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab7_1_1_1_2 hd_h_ch16.appf.tab7_1_1_2_8 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">43</td><td headers="hd_h_ch16.appf.tab7_1_1_1_2 hd_h_ch16.appf.tab7_1_1_2_9 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">45</td><td headers="hd_h_ch16.appf.tab7_1_1_1_3 hd_h_ch16.appf.tab7_1_1_2_10 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab7_1_1_1_3 hd_h_ch16.appf.tab7_1_1_2_11 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 3.15 lower (5.97 to 0.33 lower)</td><td headers="hd_h_ch16.appf.tab7_1_1_1_4 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE</p>
|
|
</td><td headers="hd_h_ch16.appf.tab7_1_1_1_5 hd_b_ch16.appf.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_1 hd_h_ch16.appf.tab7_1_1_2_2 hd_h_ch16.appf.tab7_1_1_2_3 hd_h_ch16.appf.tab7_1_1_2_4 hd_h_ch16.appf.tab7_1_1_2_5 hd_h_ch16.appf.tab7_1_1_2_6 hd_h_ch16.appf.tab7_1_1_2_7 hd_h_ch16.appf.tab7_1_1_1_2 hd_h_ch16.appf.tab7_1_1_2_8 hd_h_ch16.appf.tab7_1_1_2_9 hd_h_ch16.appf.tab7_1_1_1_3 hd_h_ch16.appf.tab7_1_1_2_10 hd_h_ch16.appf.tab7_1_1_2_11 hd_h_ch16.appf.tab7_1_1_1_4 hd_h_ch16.appf.tab7_1_1_1_5" id="hd_b_ch16.appf.tab7_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Compressive symptoms (follow-up 6 months; measured with: VAS, 0-10, higher is worse)</th></tr><tr><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_1 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_2 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_3 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_4 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_5 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_6 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_7 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab7_1_1_1_2 hd_h_ch16.appf.tab7_1_1_2_8 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">44</td><td headers="hd_h_ch16.appf.tab7_1_1_1_2 hd_h_ch16.appf.tab7_1_1_2_9 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">45</td><td headers="hd_h_ch16.appf.tab7_1_1_1_3 hd_h_ch16.appf.tab7_1_1_2_10 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab7_1_1_1_3 hd_h_ch16.appf.tab7_1_1_2_11 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 0.2 lower (0.55 lower to 0.15 higher)</td><td headers="hd_h_ch16.appf.tab7_1_1_1_4 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>LOW</p>
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</td><td headers="hd_h_ch16.appf.tab7_1_1_1_5 hd_b_ch16.appf.tab7_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_1 hd_h_ch16.appf.tab7_1_1_2_2 hd_h_ch16.appf.tab7_1_1_2_3 hd_h_ch16.appf.tab7_1_1_2_4 hd_h_ch16.appf.tab7_1_1_2_5 hd_h_ch16.appf.tab7_1_1_2_6 hd_h_ch16.appf.tab7_1_1_2_7 hd_h_ch16.appf.tab7_1_1_1_2 hd_h_ch16.appf.tab7_1_1_2_8 hd_h_ch16.appf.tab7_1_1_2_9 hd_h_ch16.appf.tab7_1_1_1_3 hd_h_ch16.appf.tab7_1_1_2_10 hd_h_ch16.appf.tab7_1_1_2_11 hd_h_ch16.appf.tab7_1_1_1_4 hd_h_ch16.appf.tab7_1_1_1_5" id="hd_b_ch16.appf.tab7_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Pain (follow-up 6 months; assessed with: Mild or greater, during procedure)</th></tr><tr><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_1 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_2 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_3 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_4 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_5 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_6 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab7_1_1_1_1 hd_h_ch16.appf.tab7_1_1_2_7 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab7_1_1_1_2 hd_h_ch16.appf.tab7_1_1_2_8 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>21/25</p>
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<p>(84%)</p>
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</td><td headers="hd_h_ch16.appf.tab7_1_1_1_2 hd_h_ch16.appf.tab7_1_1_2_9 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0%</td><td headers="hd_h_ch16.appf.tab7_1_1_1_3 hd_h_ch16.appf.tab7_1_1_2_10 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Pain OR 29.35 (9.65 to 89.23)</td><td headers="hd_h_ch16.appf.tab7_1_1_1_3 hd_h_ch16.appf.tab7_1_1_2_11 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">840 more per 1000 (from 690 more to 990 more)<sup>3</sup></td><td headers="hd_h_ch16.appf.tab7_1_1_1_4 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁⨁⨁◯</p>
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<p>MODERATE</p>
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</td><td headers="hd_h_ch16.appf.tab7_1_1_1_5 hd_b_ch16.appf.tab7_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.appf.tab7_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.appf.tab7_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.appf.tab7_3"><p class="no_margin">Zero events in control arm</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16appftab8"><div id="ch16.appf.tab8" class="table"><h3><span class="label">Table 24</span><span class="title">Clinical evidence profile: RFA vs Surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appf.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appf.tab8_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.appf.tab8_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch16.appf.tab8_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch16.appf.tab8_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch16.appf.tab8_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab8_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch16.appf.tab8_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab8_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch16.appf.tab8_1_1_1_1" id="hd_h_ch16.appf.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch16.appf.tab8_1_1_1_1" id="hd_h_ch16.appf.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch16.appf.tab8_1_1_1_1" id="hd_h_ch16.appf.tab8_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch16.appf.tab8_1_1_1_1" id="hd_h_ch16.appf.tab8_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch16.appf.tab8_1_1_1_1" id="hd_h_ch16.appf.tab8_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch16.appf.tab8_1_1_1_1" id="hd_h_ch16.appf.tab8_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch16.appf.tab8_1_1_1_1" id="hd_h_ch16.appf.tab8_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch16.appf.tab8_1_1_1_2" id="hd_h_ch16.appf.tab8_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">RFA</th><th headers="hd_h_ch16.appf.tab8_1_1_1_2" id="hd_h_ch16.appf.tab8_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Surgery</th><th headers="hd_h_ch16.appf.tab8_1_1_1_3" id="hd_h_ch16.appf.tab8_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch16.appf.tab8_1_1_1_3" id="hd_h_ch16.appf.tab8_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_1 hd_h_ch16.appf.tab8_1_1_2_2 hd_h_ch16.appf.tab8_1_1_2_3 hd_h_ch16.appf.tab8_1_1_2_4 hd_h_ch16.appf.tab8_1_1_2_5 hd_h_ch16.appf.tab8_1_1_2_6 hd_h_ch16.appf.tab8_1_1_2_7 hd_h_ch16.appf.tab8_1_1_1_2 hd_h_ch16.appf.tab8_1_1_2_8 hd_h_ch16.appf.tab8_1_1_2_9 hd_h_ch16.appf.tab8_1_1_1_3 hd_h_ch16.appf.tab8_1_1_2_10 hd_h_ch16.appf.tab8_1_1_2_11 hd_h_ch16.appf.tab8_1_1_1_4 hd_h_ch16.appf.tab8_1_1_1_5" id="hd_b_ch16.appf.tab8_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Quality of life (follow-up 6 months; measured with: SF-36, general health, 0-100, higher is better)</th></tr><tr><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_1 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_2 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_3 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_4 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_5 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_6 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_7 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab8_1_1_1_2 hd_h_ch16.appf.tab8_1_1_2_8 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">108</td><td headers="hd_h_ch16.appf.tab8_1_1_1_2 hd_h_ch16.appf.tab8_1_1_2_9 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">108</td><td headers="hd_h_ch16.appf.tab8_1_1_1_3 hd_h_ch16.appf.tab8_1_1_2_10 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab8_1_1_1_3 hd_h_ch16.appf.tab8_1_1_2_11 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 1.8 higher (0.2 to 3.4 higher)</td><td headers="hd_h_ch16.appf.tab8_1_1_1_4 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab8_1_1_1_5 hd_b_ch16.appf.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_1 hd_h_ch16.appf.tab8_1_1_2_2 hd_h_ch16.appf.tab8_1_1_2_3 hd_h_ch16.appf.tab8_1_1_2_4 hd_h_ch16.appf.tab8_1_1_2_5 hd_h_ch16.appf.tab8_1_1_2_6 hd_h_ch16.appf.tab8_1_1_2_7 hd_h_ch16.appf.tab8_1_1_1_2 hd_h_ch16.appf.tab8_1_1_2_8 hd_h_ch16.appf.tab8_1_1_2_9 hd_h_ch16.appf.tab8_1_1_1_3 hd_h_ch16.appf.tab8_1_1_2_10 hd_h_ch16.appf.tab8_1_1_2_11 hd_h_ch16.appf.tab8_1_1_1_4 hd_h_ch16.appf.tab8_1_1_1_5" id="hd_b_ch16.appf.tab8_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Quality of life (follow-up 6 months; measured with: SF-36, vitality, 0-100, higher is better)</th></tr><tr><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_1 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_2 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_3 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_4 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_5 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_6 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_7 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab8_1_1_1_2 hd_h_ch16.appf.tab8_1_1_2_8 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">108</td><td headers="hd_h_ch16.appf.tab8_1_1_1_2 hd_h_ch16.appf.tab8_1_1_2_9 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">108</td><td headers="hd_h_ch16.appf.tab8_1_1_1_3 hd_h_ch16.appf.tab8_1_1_2_10 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab8_1_1_1_3 hd_h_ch16.appf.tab8_1_1_2_11 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 3.8 higher (1.56 to 6.04 higher)</td><td headers="hd_h_ch16.appf.tab8_1_1_1_4 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab8_1_1_1_5 hd_b_ch16.appf.tab8_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_1 hd_h_ch16.appf.tab8_1_1_2_2 hd_h_ch16.appf.tab8_1_1_2_3 hd_h_ch16.appf.tab8_1_1_2_4 hd_h_ch16.appf.tab8_1_1_2_5 hd_h_ch16.appf.tab8_1_1_2_6 hd_h_ch16.appf.tab8_1_1_2_7 hd_h_ch16.appf.tab8_1_1_1_2 hd_h_ch16.appf.tab8_1_1_2_8 hd_h_ch16.appf.tab8_1_1_2_9 hd_h_ch16.appf.tab8_1_1_1_3 hd_h_ch16.appf.tab8_1_1_2_10 hd_h_ch16.appf.tab8_1_1_2_11 hd_h_ch16.appf.tab8_1_1_1_4 hd_h_ch16.appf.tab8_1_1_1_5" id="hd_b_ch16.appf.tab8_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Quality of life (follow-up 6 months; measured with: SF-36, mental health, 0-100, higher is better)</th></tr><tr><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_1 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_2 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_3 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_4 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_5 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_6 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab8_1_1_1_1 hd_h_ch16.appf.tab8_1_1_2_7 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab8_1_1_1_2 hd_h_ch16.appf.tab8_1_1_2_8 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">108</td><td headers="hd_h_ch16.appf.tab8_1_1_1_2 hd_h_ch16.appf.tab8_1_1_2_9 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">108</td><td headers="hd_h_ch16.appf.tab8_1_1_1_3 hd_h_ch16.appf.tab8_1_1_2_10 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch16.appf.tab8_1_1_1_3 hd_h_ch16.appf.tab8_1_1_2_11 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 1.6 higher (0.11 to 3.09 higher)</td><td headers="hd_h_ch16.appf.tab8_1_1_1_4 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab8_1_1_1_5 hd_b_ch16.appf.tab8_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.appf.tab8_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.appf.tab8_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch16appftab9"><div id="ch16.appf.tab9" class="table"><h3><span class="label">Table 25</span><span class="title">Clinical evidence profile: Microwave ablation vs Surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appf.tab9/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appf.tab9_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch16.appf.tab9_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch16.appf.tab9_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch16.appf.tab9_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch16.appf.tab9_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab9_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch16.appf.tab9_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch16.appf.tab9_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch16.appf.tab9_1_1_1_1" id="hd_h_ch16.appf.tab9_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch16.appf.tab9_1_1_1_1" id="hd_h_ch16.appf.tab9_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch16.appf.tab9_1_1_1_1" id="hd_h_ch16.appf.tab9_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch16.appf.tab9_1_1_1_1" id="hd_h_ch16.appf.tab9_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch16.appf.tab9_1_1_1_1" id="hd_h_ch16.appf.tab9_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch16.appf.tab9_1_1_1_1" id="hd_h_ch16.appf.tab9_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch16.appf.tab9_1_1_1_1" id="hd_h_ch16.appf.tab9_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch16.appf.tab9_1_1_1_2" id="hd_h_ch16.appf.tab9_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Microwave ablation</th><th headers="hd_h_ch16.appf.tab9_1_1_1_2" id="hd_h_ch16.appf.tab9_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Surgery</th><th headers="hd_h_ch16.appf.tab9_1_1_1_3" id="hd_h_ch16.appf.tab9_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch16.appf.tab9_1_1_1_3" id="hd_h_ch16.appf.tab9_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_1 hd_h_ch16.appf.tab9_1_1_2_2 hd_h_ch16.appf.tab9_1_1_2_3 hd_h_ch16.appf.tab9_1_1_2_4 hd_h_ch16.appf.tab9_1_1_2_5 hd_h_ch16.appf.tab9_1_1_2_6 hd_h_ch16.appf.tab9_1_1_2_7 hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_8 hd_h_ch16.appf.tab9_1_1_2_9 hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_10 hd_h_ch16.appf.tab9_1_1_2_11 hd_h_ch16.appf.tab9_1_1_1_4 hd_h_ch16.appf.tab9_1_1_1_5" id="hd_b_ch16.appf.tab9_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Nodule volume (follow-up 12 months; Better indicated by lower values)</th></tr><tr><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_1 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_2 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_3 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_4 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_5 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_6 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_7 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_8 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">28</td><td headers="hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_9 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">24</td><td headers="hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_10 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-<sup>3</sup></td><td headers="hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_11 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Mean final nodule volume in intervention group 0.69ml<sup>3</sup></td><td headers="hd_h_ch16.appf.tab9_1_1_1_4 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch16.appf.tab9_1_1_1_5 hd_b_ch16.appf.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_1 hd_h_ch16.appf.tab9_1_1_2_2 hd_h_ch16.appf.tab9_1_1_2_3 hd_h_ch16.appf.tab9_1_1_2_4 hd_h_ch16.appf.tab9_1_1_2_5 hd_h_ch16.appf.tab9_1_1_2_6 hd_h_ch16.appf.tab9_1_1_2_7 hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_8 hd_h_ch16.appf.tab9_1_1_2_9 hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_10 hd_h_ch16.appf.tab9_1_1_2_11 hd_h_ch16.appf.tab9_1_1_1_4 hd_h_ch16.appf.tab9_1_1_1_5" id="hd_b_ch16.appf.tab9_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Hoarseness (temporary) (follow-up 12 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_1 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_2 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_3 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_4 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_5 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_6 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_7 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_8 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>1/28</p>
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<p>(3.6%)</p>
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|
</td><td headers="hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_9 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">8.3%</td><td headers="hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_10 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.43 (0.04 to 4.44)</td><td headers="hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_11 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">47 fewer per 1000 (from 80 fewer to 286 more)</td><td headers="hd_h_ch16.appf.tab9_1_1_1_4 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch16.appf.tab9_1_1_1_5 hd_b_ch16.appf.tab9_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_1 hd_h_ch16.appf.tab9_1_1_2_2 hd_h_ch16.appf.tab9_1_1_2_3 hd_h_ch16.appf.tab9_1_1_2_4 hd_h_ch16.appf.tab9_1_1_2_5 hd_h_ch16.appf.tab9_1_1_2_6 hd_h_ch16.appf.tab9_1_1_2_7 hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_8 hd_h_ch16.appf.tab9_1_1_2_9 hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_10 hd_h_ch16.appf.tab9_1_1_2_11 hd_h_ch16.appf.tab9_1_1_1_4 hd_h_ch16.appf.tab9_1_1_1_5" id="hd_b_ch16.appf.tab9_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Post-operative pain (temporary) (follow-up 12 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_1 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_2 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_3 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_4 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_5 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_6 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_7 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_8 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>2/28</p>
|
|
<p>(7.1%)</p>
|
|
</td><td headers="hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_9 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">91.7%</td><td headers="hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_10 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.08 (0.02 to 0.30)</td><td headers="hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_11 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">844 fewer per 1000 (from 642 fewer to 899 fewer)</td><td headers="hd_h_ch16.appf.tab9_1_1_1_4 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_ch16.appf.tab9_1_1_1_5 hd_b_ch16.appf.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_1 hd_h_ch16.appf.tab9_1_1_2_2 hd_h_ch16.appf.tab9_1_1_2_3 hd_h_ch16.appf.tab9_1_1_2_4 hd_h_ch16.appf.tab9_1_1_2_5 hd_h_ch16.appf.tab9_1_1_2_6 hd_h_ch16.appf.tab9_1_1_2_7 hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_8 hd_h_ch16.appf.tab9_1_1_2_9 hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_10 hd_h_ch16.appf.tab9_1_1_2_11 hd_h_ch16.appf.tab9_1_1_1_4 hd_h_ch16.appf.tab9_1_1_1_5" id="hd_b_ch16.appf.tab9_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Resolution of compressive symptoms (follow-up 12 months)</th></tr><tr><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_1 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_2 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_3 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_4 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_5 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_6 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch16.appf.tab9_1_1_1_1 hd_h_ch16.appf.tab9_1_1_2_7 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_8 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>10/10</p>
|
|
<p>(100%)</p>
|
|
</td><td headers="hd_h_ch16.appf.tab9_1_1_1_2 hd_h_ch16.appf.tab9_1_1_2_9 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">100%</td><td headers="hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_10 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 1 (0.84 to 1.19)</td><td headers="hd_h_ch16.appf.tab9_1_1_1_3 hd_h_ch16.appf.tab9_1_1_2_11 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0 fewer per 1000 (from 160 fewer to 190 more)</td><td headers="hd_h_ch16.appf.tab9_1_1_1_4 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW</p>
|
|
</td><td headers="hd_h_ch16.appf.tab9_1_1_1_5 hd_b_ch16.appf.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch16.appf.tab9_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch16.appf.tab9_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch16.appf.tab9_3"><p class="no_margin">95% confidence intervals cannot be calculated as no SD available for surgery (all participants with whole nodule removed)</p></div></dd></dl></dl></div></div></div></article><article data-type="fig" id="figobch16appgfig1"><div id="ch16.appg.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2034.%20Flow%20chart%20of%20health%20economic%20study%20selection%20for%20the%20guideline.&p=BOOKS&id=577222_ch16appgf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577222/bin/ch16appgf1.jpg" alt="Figure 34. Flow chart of health economic study selection for the guideline." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 34</span><span class="title">Flow chart of health economic study selection for the guideline</span></h3><div class="caption"><p>* Non-relevant population, intervention, comparison, design or setting; non-English language TFT; thyroid function test, FNA; fine-needle aspiration, US; ultrasound, RAI; radioactive iodine, ATDs; antithyroid drugs, Mang; management, SCH; Subclinical hypothyroidism, SCT; Subclinical thyrotoxicosis.</p></div></div></article><article data-type="table-wrap" id="figobch16appjtab1"><div id="ch16.appj.tab1" class="table"><h3><span class="label">Table 26</span><span class="title">Studies excluded from the clinical review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appj.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Exclusion reason</th></tr></thead><tbody><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Baek 2010<a class="bibr" href="#ch16.ref2" rid="ch16.ref2"><sup>2</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bayani 2012<a class="bibr" href="#ch16.ref4" rid="ch16.ref4"><sup>4</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No usable outcomes</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chen 2016<a class="bibr" href="#ch16.ref9" rid="ch16.ref9"><sup>9</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SR (checked for references)</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cheng 2017<a class="bibr" href="#ch16.ref10" rid="ch16.ref10"><sup>10</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cheung 1989<a class="bibr" href="#ch16.ref11" rid="ch16.ref11"><sup>11</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No usable outcomes</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chung 2017<a class="bibr" href="#ch16.ref12" rid="ch16.ref12"><sup>12</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review is not relevant to review question or unclear PICO</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dossing 2007<a class="bibr" href="#ch16.ref15" rid="ch16.ref15"><sup>15</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate comparison</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dossing 2013<a class="bibr" href="#ch16.ref16" rid="ch16.ref16"><sup>16</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Faggiano 2012<a class="bibr" href="#ch16.ref17" rid="ch16.ref17"><sup>17</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not review population</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ferreira 2016<a class="bibr" href="#ch16.ref18" rid="ch16.ref18"><sup>18</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gambelunghe 2006<a class="bibr" href="#ch16.ref19" rid="ch16.ref19"><sup>19</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gangappa 2016<a class="bibr" href="#ch16.ref20" rid="ch16.ref20"><sup>20</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gharib 1998<a class="bibr" href="#ch16.ref22" rid="ch16.ref22"><sup>22</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SR (checked for references)</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Giovanella 2018<a class="bibr" href="#ch16.ref23" rid="ch16.ref23"><sup>23</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ha 2015<a class="bibr" href="#ch16.ref25" rid="ch16.ref25"><sup>25</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SR (checked for references)</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Jin 2018<a class="bibr" href="#ch16.ref26" rid="ch16.ref26"><sup>26</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kim 1997<a class="bibr" href="#ch16.ref28" rid="ch16.ref28"><sup>28</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not in English</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Korkusuz 2018<a class="bibr" href="#ch16.ref29" rid="ch16.ref29"><sup>29</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">La rosa 1995<a class="bibr" href="#ch16.ref30" rid="ch16.ref30"><sup>30</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No usable outcomes</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lang 2017<a class="bibr" href="#ch16.ref32" rid="ch16.ref32"><sup>32</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SR (checked for references)</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lang 2017<a class="bibr" href="#ch16.ref31" rid="ch16.ref31"><sup>31</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lang 2017<a class="bibr" href="#ch16.ref33" rid="ch16.ref33"><sup>33</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pacella 2017<a class="bibr" href="#ch16.ref38" rid="ch16.ref38"><sup>38</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sdano 2005<a class="bibr" href="#ch16.ref43" rid="ch16.ref43"><sup>43</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SR (checked for references)</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sewefy 2017<a class="bibr" href="#ch16.ref44" rid="ch16.ref44"><sup>44</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Verde 1994<a class="bibr" href="#ch16.ref46" rid="ch16.ref46"><sup>46</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wang 2017<a class="bibr" href="#ch16.ref47" rid="ch16.ref47"><sup>47</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SR (checked for references)</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Yan 2018<a class="bibr" href="#ch16.ref49" rid="ch16.ref49"><sup>49</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not minimum duration</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Yue 2017<a class="bibr" href="#ch16.ref52" rid="ch16.ref52"><sup>52</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Yue 2017<a class="bibr" href="#ch16.ref51" rid="ch16.ref51"><sup>51</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Correction only</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zingrillo 2000<a class="bibr" href="#ch16.ref56" rid="ch16.ref56"><sup>56</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch16.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zingrillo 2003<a class="bibr" href="#ch16.ref55" rid="ch16.ref55"><sup>55</sup></a></td><td headers="hd_h_ch16.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate comparison</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch16appktab1"><div id="ch16.appk.tab1" class="table"><h3><span class="title">Criteria for selecting high-priority research recommendations</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577222/table/ch16.appk.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch16.appk.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_ch16.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PICO question</th><td headers="hd_b_ch16.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Population: People with symptomatic benign thyroid disease.</p>
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<p>Intervention(s): Percutaneous thermal ablation (such as Cryotherapy, Microwave Ablation, Laser Ablation and High Intensity Focused Ultrasound).</p>
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<p>Comparison: Open surgery</p>
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<p>Outcome(s): Symptom reduction, incidence and severity of side effects, cost, quality of life.</p>
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</td></tr><tr><th id="hd_b_ch16.appk.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Importance to patients or the population</th><td headers="hd_b_ch16.appk.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The use of less invasive treatments for thyroid nodules causing symptoms is important for patients who do not want to have a scar in the neck or be exposed to potential complications of thyroid surgery such as hypoparathyroidism and recurrent laryngeal nerve damage. In addition, these treatments may have important roles for patients with co-morbidities in whom surgery may be relatively contra-indicated. Furthermore if research supports the cost-effectiveness of these techniques, important savings could be made for the NHS and society as a whole.</td></tr><tr><th id="hd_b_ch16.appk.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevance to NICE guidance</th><td headers="hd_b_ch16.appk.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Research would address the lack of available evidence for the clinical and cost effectiveness of less invasive therapies for people with benign thyroid nodules This would allow the development of evidence-based guidelines to clearly advise for or against the use of percutaneous thermal ablation across the UK either in place of, or alongside currently established surgical techniques.</td></tr><tr><th id="hd_b_ch16.appk.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevance to the NHS</th><td headers="hd_b_ch16.appk.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Evidence based recommendations would enable clinicians to guide patients to the most clinically and cost-effective, management strategy for benign thyroid nodules, resulting in improved patient outcomes at a low cost/ without increased resource impact.</td></tr><tr><th id="hd_b_ch16.appk.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">National priorities</th><td headers="hd_b_ch16.appk.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A trial would support a national evidence based approach to the management of benign thyroid nodules with the potential of expanding the use of novel, less invasive treatment strategies not widely available in current practice.</td></tr><tr><th id="hd_b_ch16.appk.tab1_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Current evidence base</th><td headers="hd_b_ch16.appk.tab1_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">There is currently very little evidence available regarding the use of non-invasive treatments such as cryotherapy, microwave ablation and high intensity focused ultrasound for people with benign thyroid nodules to support their wide use in the UK’s clinical setting.</td></tr><tr><th id="hd_b_ch16.appk.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Equality</th><td headers="hd_b_ch16.appk.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The recommendation is not thought to affect equality. The trial would be specific to people with benign thyroid nodules as the examined treatment strategies are considered to be of potential benefit to people with this particular type pf thyroid enlargement.</td></tr><tr><th id="hd_b_ch16.appk.tab1_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_ch16.appk.tab1_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Randomised controlled trial with health-economic analyses.</td></tr><tr><th id="hd_b_ch16.appk.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Feasibility</th><td headers="hd_b_ch16.appk.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Benign thyroid nodules are common and surgical intervention not infrequent in this patient population. Percutaneous thermal ablation requires specific equipment and training but this is available in the UK. Trials are therefore considered feasible.</td></tr><tr><th id="hd_b_ch16.appk.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other comments</th><td headers="hd_b_ch16.appk.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The trial may attract commercial funders in the thermally ablative techniques as several are available both within each technique and also between the different thermal modalities themselves.</td></tr><tr><th id="hd_b_ch16.appk.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Importance</th><td headers="hd_b_ch16.appk.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High: the research is essential to inform future recommendations for the management of patients with benign thyroid nodules.</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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