Cervical spine screening with CT in trauma patients: A cost- effectiveness analysis

C. Craig Blackmore, Scott D. Ramsey, Frederick A. Mann, Richard (Rick) Deyo

Research output: Contribution to journalArticle

230 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)117-125
Number of pages9
JournalRadiology
Volume212
Issue number1
StatePublished - Jul 1999
Externally publishedYes

Fingerprint

Cost-Benefit Analysis
Spine
Tomography
Wounds and Injuries
Paralysis
Costs and Cost Analysis
Radiography
Quality-Adjusted Life Years
Decision Support Techniques
Outcome Assessment (Health Care)

Keywords

  • Cost-effectiveness
  • CT, helical
  • Spine, CT
  • Spine, fractures
  • Trauma

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Blackmore, C. C., Ramsey, S. D., Mann, F. A., & Deyo, R. R. (1999). Cervical spine screening with CT in trauma patients: A cost- effectiveness analysis. Radiology, 212(1), 117-125.

Cervical spine screening with CT in trauma patients : A cost- effectiveness analysis. / Blackmore, C. Craig; Ramsey, Scott D.; Mann, Frederick A.; Deyo, Richard (Rick).

In: Radiology, Vol. 212, No. 1, 07.1999, p. 117-125.

Research output: Contribution to journalArticle

Blackmore, CC, Ramsey, SD, Mann, FA & Deyo, RR 1999, 'Cervical spine screening with CT in trauma patients: A cost- effectiveness analysis', Radiology, vol. 212, no. 1, pp. 117-125.
Blackmore, C. Craig ; Ramsey, Scott D. ; Mann, Frederick A. ; Deyo, Richard (Rick). / Cervical spine screening with CT in trauma patients : A cost- effectiveness analysis. In: Radiology. 1999 ; Vol. 212, No. 1. pp. 117-125.
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