Materials and Methods
We computed a decision tree model to assess the overall benefit resulting from each of the treatment strategies for lrPTMCs (surgical vs. AS), by incorporating the effect ofBRAF testing. We used Markov models, which are used for decision-making in health management to model the probabilities of different states and the rates of transitions among them. The model schematic is presented in Figure 1, and the detailed model can be found in the Supp. Materials. We compared the overall QALYs resulting from the management of patients with PTMC using the traditional surgical management with hemithyroidectomy (HT) compared to active surveillance (AS). We used TreeAge Software Pro version 2021 (TreeAge Software, Inc., Williamstown, MA USA) to construct the model. Additional analyses were performed using MATLAB (MathWorks 2020a). The analysis methodology and results are reported according to the Standards for QUality Improvement Reporting Excellence (SQUIRE 2.0).
Ethical approval: As the model is based on published data from previous studies and databases, review board exemption was accepted.