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Leading thyroidologists in the United States and in Europe have most frequently recommended radioiodine (RAI) therapy when elimination of a solitary toxic nodule is indicated (1, 2). Interdisciplinary guidelines in Germany, authorized by the national associations of nuclear medicine, endocrinology and surgery, also give RAI administration as the therapy of choice for this indication (3). How then can the contradictory results of the cost-effectiveness analysis of Vidal-Trecan et al. in France (4) be explained? This analysis shows RAI administration to be an effective therapy only in the oldest of patients. In their ‘Methods’ chapter the authors Vidal-Trecan et al. (4) explain their methods of estimation and decision trees, indicating the crucial factors on which their analysis is based.

Lifetime follow-up care is necessary for all patients with treated thyroid nodules