Auditory brainstem response prior to MRI compared to standalone MRI in the detection of vestibular schwannoma: A modelling study.
Clin Otolaryngol
; 47(2): 295-303, 2022 03.
Article
em En
| MEDLINE
| ID: mdl-34784107
ABSTRACT
OBJECTIVES:
To determine the cost-effectiveness of auditory brainstem response prior to MRI (ABR-MRI) compared to standalone MRI to diagnose vestibular schwannoma.DESIGN:
A state transition model was developed to simulate costs and effects (quality-adjusted life years [QALY]) for both diagnostic strategies for patients suspected of a vestibular schwannoma. Model input was derived from literature, hospital databases and expert opinions. Scenario and sensitivity analyses addressed model uncertainty.RESULTS:
Over a lifetime horizon, ABR-MRI resulted in a limited cost-saving of 68 or 98 per patient (dependent on MRI sequence) and a health loss of 0.005 QALYs over standalone MRI. ABR-MRI, however, did miss patients with other important pathology (2% of the population) that would have been detected when using standalone MRI. In total, 14 203 or 19 550 could be saved per lost QALY if ABR-MRI was used instead of standalone MRI. The results were sensitive to the detection rate of vestibular schwannoma and health-related quality of life of missed patients.CONCLUSION:
The cost-saving with ABR-MRI does not seem to outweigh the number of missed patients with VS and other important pathologies that would have been detected when using standalone MRI.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
/
Neuroma Acústico
/
Potenciais Evocados Auditivos do Tronco Encefálico
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Análise Custo-Benefício
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Clin Otolaryngol
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Holanda