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

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.

journal_name

Radiology

journal_title

Radiology

authors

Blackmore CC,Ramsey SD,Mann FA,Deyo RA

doi

10.1148/radiology.212.1.r99jl08117

subject

Has Abstract

pub_date

1999-07-01 00:00:00

pages

117-25

issue

1

eissn

0033-8419

issn

1527-1315

journal_volume

212

pub_type

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