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  1. Cost effectiveness and outcome assessment of magnetic resonance imaging in diagnosing cord compression.

    Article - En anglais

    Background

    This study was designed to investigate the costs associated with the use of magnetic resonance imaging (MRI) in the workup of spinal cord compression caused by metastatic disease, an area in which it has proven to be diagnostically useful.

    Methods

    The study was divided into two parts.

    Part 1 consisted of a retrospective review of the hospital charts of 46 patients, half of whom were diagnosed with cord compression in the pre-MRI era and the other half diagnosed after MRI availability ; costs for these two groups were compared.

    Part 2 consisted of a review of several major studies comparing the sensitivities and specificities of MRI with alternative imaging techniques, usually myelography.

    Cost effectiveness and cost/cost ratios were derived for diagnostic usefulness using prevalence, sensitivity, specificity, and cost estimates of MRI and its alternatives, including costs of false-negative and false-positive testing.

    Results

    Our hospital-based experience yielded an average cost of $3664 per patient without MRI and $2283 per patient when MRI was available (1991 dollar amounts).

    Conclusion

    This work suggests that MRI may result in significant economic benefits in diagnosing metastatic cord compression, but further work is needed on physician behavior and referral patterns with MRI versus myelography as is long term follow-up for potential reductions in patient debility using MRI.

    Cancer 1995 ; 75 : 2579-86.

    Mots-clés Pascal : Métastase, Homme, Compression par tumeur, Moelle épinière, Diagnostic, Imagerie RMN, Analyse coût efficacité, Economie santé, Tumeur maligne, Système nerveux pathologie, Système nerveux central pathologie, Moelle épinière pathologie

    Mots-clés Pascal anglais : Metastasis, Human, Tumoral compression, Spinal cord, Diagnosis, Nuclear magnetic resonance imaging, Cost efficiency analysis, Health economy, Malignant tumor, Nervous system diseases, Central nervous system disease, Spinal cord disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0453869

    Code Inist : 002B24A06. Création : 01/03/1996.