To determine the incremental cost-effectiveness of magnetic resonance imaging (MRI) and computed tomography (CT) in young adults presenting with equivocal neurological signs and symptoms.
A decision analysis of long-term survival using accuracy data from a diagnostic technology assessment of MRI and CT in patients with suspected multiple sclerosis, information from the medical literature, and clinical assumptions.
In the baseline analysis, at 30% likelihood of an underlying neurologic disease, MRI use has an incremental cost of $101,670 for each additional quality-adjusted life-year saved compared with $20,290for CT use.
As the probability of disease increases, further MRI use becomes a cost-effective alternative costing $30,000 for each quality-adjusted life-year saved.
If a negative MRI result provides reassurance, the incremental costs of immediate MRI use decreases and falls below $25,000 for each quality-adjusted life-year saved no matter the likelihood of disease.
For most individuals with neurological symptoms or signs, CT imaging is cost-effective while MR imaging is not.
The cost-effectiveness of MRI use, however, improves as the likelihood of an underlying neurological disease increases.
For selected patients who highly value diagnostic information, MRI is a reasonable and cost-effective use of medical resources when even the likelihood of disease is quite low (5%).
Mots-clés Pascal : Imagerie RMN, Tomodensitométrie, Analyse coût efficacité, Economie santé, Système nerveux pathologie, Adulte jeune, Homme, Technique, Evaluation, Diagnostic, Analyse décision, Imagerie médicale, Radiodiagnostic
Mots-clés Pascal anglais : Nuclear magnetic resonance imaging, Computerized axial tomography, Cost efficiency analysis, Health economy, Nervous system diseases, Young adult, Human, Technique, Evaluation, Diagnosis, Decision analysis, Medical imagery, Radiodiagnosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0287008
Code Inist : 002B30A01C. Création : 15/07/1997.