3.1 To inform the committee, NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 8 sources, which was discussed by the committee. The evidence included 1 systematic review, 4 comparative studies and 3 case series, and is presented in table 2 of the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The specialist advisers and the committee considered the key efficacy outcomes to be: nodule volume reduction and improvement of nodule-related symptoms.
3.3 The specialist advisers and the committee considered the key safety outcomes to be: pain, damage to the recurrent laryngeal nerve and to other adjacent structures.
3.4 Patient commentary was sought but none was received.
3.5 Patients should have assessment in a thyroid clinic to exclude malignancy.
3.6 The committee was informed that there was an upper limit to the size of nodules that have been treated with this procedure, but the software used for this procedure is continuously improving and bigger nodules can now be treated.
3.7 The committee noted that there is little evidence for using the procedure in treating thyrotoxicosis caused by hyperfunctioning nodules.