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.