Abstract
PURPOSE: To investigate the cost-effectiveness of computed tomography (CT) relative to radiography for cervical spine screening in trauma patients. MATERIALS AND METHODS: A decision analysis model was constructed to compare the incremental cost-effectiveness of radiography and CT as primary cervical spine screening modalities in trauma patients. Analyses were performed from a societal perspective, and probability and cost estimates from the literature and institutional experience were used. In separate cost-effectiveness analyses, hypothetical cohorts of trauma patients from three defined clinical scenarios were considered: high, moderate, and low risk for cervical spine fracture. Outcome measures included cases of paralysis prevented, total cost of screening strategies, and incremental cost-effectiveness ratios. RESULTS: In high-risk patients, screening with CT is a dominant strategy that prevents cases of paralysis and saves money for society. In moderate-risk patients, screening with CT is cost-effective with reference-case assumptions and within the range of most sensitivity analyses. In the low-risk group, CT screening helps prevent cases of paralysis, but the incremental cost- effectiveness ratio is high (>$80,000 per quality-adjusted life year). CONCLUSION: CT is the preferred cervical spine screening modality in trauma patients at high and moderate risk for cervical spine fracture.
Original language | English (US) |
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Pages (from-to) | 117-125 |
Number of pages | 9 |
Journal | RADIOLOGY |
Volume | 212 |
Issue number | 1 |
DOIs | |
State | Published - Jul 1999 |
Externally published | Yes |
Keywords
- CT, helical
- Cost-effectiveness
- Spine, CT
- Spine, fractures
- Trauma
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging