Cost analysis of asymmetric sensorineural hearing loss investigations.
Laryngoscope
; 120(9): 1832-6, 2010 Sep.
Article
en En
| MEDLINE
| ID: mdl-20661936
ABSTRACT
OBJECTIVES/HYPOTHESIS:
The purpose of this study is to critically evaluate the typical cost of asymmetrical sensorineural hearing loss (ASNHL) work-up, and to compare the positive predictive value from this common presenting symptom. STUDYDESIGN:
Retrospective chart review from two major otolaryngology centers.METHODS:
We reviewed charts from patients presenting to New York Eye and Ear Infirmary between January 1, 2006 and December 31, 2006, and the University of Minnesota between December 1, 2002 and November 30, 2007 with ASNHL. Diagnostic information included magnetic resonance imaging (MRI) and serum laboratory values (antinuclear antibodies, erythrocyte sedimentation rate, Lyme, rapid plasma reagin, and thyroid-stimulating hormone). We calculated positive rate according to each item of diagnosis. To estimate cost-benefit, we further calculated the average cost for identifying a patient with a positive result.RESULTS:
The total cost was $263,535, whereas the average cost for identifying a positive patient was $146,40.81. The total lab cost was $16,935 and the total imaging cost was $246,600. The average cost for identifying a positive patient based on MRI was $61,650 and $2,109 based on lab values. Of the 247 patients, only six patients (2.4%)-one patient with acoustic neuroma, two patients with syphilis, and three patients with Lyme--were identified with treatable pathology.CONCLUSIONS:
A comprehensive ASNHL work-up may not be applicable to all patients. Laboratory serologic tests are highly cost effective in diagnosing treatable causes of ASNHL, such as syphilis and Lyme. Although radiographic imaging with MRI is not as cost effective, its value in detecting for acoustic neuroma is undeniable.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Análisis Químico de la Sangre
/
Imagen por Resonancia Magnética
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Pérdida Auditiva Unilateral
/
Pérdida Auditiva Sensorineural
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Laryngoscope
Asunto de la revista:
OTORRINOLARINGOLOGIA
Año:
2010
Tipo del documento:
Article
País de afiliación:
Estados Unidos