Comparing Two Approaches for Thyroidectomy: A Health Technology Assessment through DMAIC Cycle

Abstract

Total thyroidectomy is very common in endocrine surgery and the haemostasis can be obtained in different ways across surgery; recently, some devices have been developed to support this surgical phase. In this paper, a health technology assessment is conducted through the define, measure, analyse, improve, and control cycle of the Six Sigma methodology to compare traditional total thyroidectomy with the surgical operation performed through a new device in an overall population of 104 patients. Length of hospital stay, drain output, and time for surgery were considered the critical to qualities in order to compare the surgical approaches which can be considered equal regarding the organizational, ethical, and security impact. Statistical tests (Kolmogorov–Smirnov, t test, ANOVA, Mann–Whitney, and Kruskal–Wallis tests) and visual management diagrams were employed to compare the approaches, but no statistically significant difference was found between them. Considering these results, this study shows that the introduction of the device to perform total thyroidectomy does not guarantee appreciable clinical advantages. A cost analysis to quantify the economic impact of the device into the practice could be a future development. Healthy policy leaders and clinicians who are requested to make decisions regarding the supply of biomedical technologies could benefit from this research.

Comparison of postoperative complications using Harmonic scalpel and LigaSure in thyroid surgery

“…in general, 2-12% of the patients who undergo total thyroidectomy show permanent hypoparathyroidism after surgery, while the incidence of transient hypoparathyroidism between total thyroidectomy and near-total thyroidectomy is 26% and 9,8 %, respectively. However, it is noteworthy that Makay mentions in his article that if two parathyroids are identified and saved, it is enough to avoid permanent hypoparathyroidism after thyroidectomy [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. the parathyroid glands are crucial for calcium-level homeostasis; hence, their excision or devascularization is responsible for hypoparathyroidism, while imminent temporary or permanent hypocalcemia is also expected.…”

Prioritizing and Overcoming Barriers to e-Health Use among Elderly People: Implementation of the Analytical Hierarchical Process (AHP)

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Revolutionising Quality Management in the Oral Pathology Laboratory: A Deep Dive Into the Six Sigma Methodology

“…It helps in recognising and assessing any financial uncertainties through an in-depth examination of the possible negative impacts that process modifications might have on the financial aspects of an organization. Managing these risks is crucial for making financial-altering decisions that will ensure stability and prevent unwanted expenditures [ 18 ].…”

“…High-level dedication and knowledge of the laboratory in-charge and personnel are also needed for a successful workflow, along with the enactment of the Six Sigma strategy [ 18 ]. To obtain an effective workflow along with the application of Six Sigma, substantial dedication and expertise from both the laboratory in-charge and personnel and active participation from both sides are required.…”