Abstract
Background: Fragmented care pathways for thyroid nodular disease prolong time to decision and increase costs. “One-stop” clinics (OSCs) integrate clinical evaluation, ultrasound, ultrasound-guided fine-needle aspiration (FNA) and, when appropriate, rapid on-site evaluation (ROSE)/telecytology in a single visit.
Objective: To map organizational models of OSCs, define key performance indicators (KPIs), and summarize outcomes (time, visits, adequacy, repeat FNA, costs, patient satisfaction, safety).
Methods: Scoping review following PRISMA-ScR and JBI guidance. MEDLINE, Scopus, and Web of Science were searched (2000–August 2025). We included studies that operationalized OSCs and/or reported KPIs/outcomes. Data extraction covered organizational features, protocols (ACR/EU-TIRADS, Bethesda), flow metrics, FNA/ROSE adequacy, economics, satisfaction, and safety. Narrative synthesis was performed.
Results: Identified OSC models consistently shorten lead time to decision and reduce the number of visits. Sample adequacy is high—especially with ROSE/telecytology—thereby lowering repeat FNA rates. Patient satisfaction is high; the safety profile of FNA remains favourable. Economic analyses indicate that the cost-effectiveness of ROSE is context-dependent and greatest when baseline inadequacy is higher and/or ROSE costs are lower. A KPI set is proposed: lead time, proportion of “single-visit” completions, Bethesda I rate, ROSE utilization, repeat FNA ≤90 days, cost per episode, and satisfaction.
Conclusion: OSCs are an applicable, value-oriented model for thyroid diagnostics. Selective use of ROSE/telecytology and KPI-driven management enable efficient and safe implementation across diverse resource settings.