Impact and Cost Effectiveness of Videonystagmography.
Ann Otol Rhinol Laryngol
; 130(7): 718-723, 2021 Jul.
Article
in En
| MEDLINE
| ID: mdl-33124434
ABSTRACT
OBJECTIVE:
Videonystagmography (VNG) is a commonly ordered test to evaluate patients with vestibular complaints. To date, there are no evidence-based guidelines for evaluating patients presenting with vestibular symptoms. This study evaluates the cost effectiveness of VNG and the impact of VNG findings on patient management.METHODS:
Patient charts were reviewed from 3 institutions to collect the pre- and post-VNG ICD-9/10 diagnosis and treatment plan. VNG findings were recorded to calculate the incidence of abnormal findings and the incidence of change in diagnosis and/or treatment plan. The cost effectiveness of VNG was estimated based on these calculations.RESULTS:
A total of 120 patient charts were reviewed. 69/120 (57.5%; 95% CI 48.2%-66.5%) patients had abnormal findings on their VNG. A change in diagnosis was noted in 24/120 (20.0%; 95% CI 13.3%-28.3%) patients. A change in treatment plan was noted in 62/120 (51.7%; 95% CI 42.4%-60.9%) patients, and 11/120 (9.2%; 95% CI 4.7%-15.8%) had a change in diagnosis that led to change in treatment plan. Using the average Medicare reimbursement for VNG, the cost effectiveness analysis showed a cost of $869.57 per VNG with abnormal findings and a cost of $5454.55 per VNG that lead to a change in diagnosis and treatment plan.CONCLUSIONS:
VNG findings may not result in changes in clinical diagnosis. However, VNG is impactful at influencing treatment plan changes. VNG results are beneficial for counseling patients, guiding treatment plans, and managing patient expectations. When there is a clear indication, VNG testing can be cost effective in managing patients presenting with vestibular symptoms.Key words
Full text:
1
Collection:
01-internacional
Health context:
1_ASSA2030
Database:
MEDLINE
Main subject:
Video Recording
/
Vestibular Diseases
/
Cost-Benefit Analysis
/
Electronystagmography
Type of study:
Guideline
/
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Ann Otol Rhinol Laryngol
Year:
2021
Document type:
Article