| Upfront computed tomography scanning is more cost-beneficial than empiric medical therapy in the initial management of chronic rhinosinusitis. | |
| | |
MedLine Citation:
|
PMID: 22144057 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
BACKGROUND: Current treatment algorithms for patients with symptoms of chronic rhinosinusitis (CRS) recommend a trial of empiric medical therapy prior to obtaining a sinus computed tomography (CT) scan, even in cases of negative nasal endoscopy. This empiric approach evolved in an era when same day conventional CT was both impractical and economically irresponsible. The objective of this work was to determine whether upfront CT scanning is more cost-beneficial than empiric medical therapy for patients presenting with CRS symptoms but negative endoscopic findings. METHODS: A Markov economic model was employed. Medication costs, CT costs, treatment response rates, and treatment associated adverse event rates were included as model parameters. Treatment cost values were derived from Medicare. RESULTS: There is a clear cost advantage to the upfront CT algorithm over empiric therapy regardless of the availability of point-of-care CT scanning (POC-CT). This advantage persists during the sensitivity analysis when costs and response rates are fully biased toward empiric therapy. If POC-CT is available, upfront CT can save $320.50 per patient (range, $138.5-671.5). When POC-CT CT is unavailable, upfront CT savings persist at $296.60 (range, $106.09-655.40). CONCLUSION: In patients meeting symptom criteria for CRS but without endoscopic evidence of inflammation, upfront CT scanning is more cost-beneficial than empiric medical therapy. Adopting upfront CT scanning can save the U.S. healthcare system $1.2 billion dollars per year. Further, POC-CT can offer same day diagnosis, facilitate prompt treatment, and decrease unnecessary antibiotic prescriptions. © 2011 ARS-AAOA, LLC. |
| | |
Authors:
|
Randy Leung; Robert Kern; Neil Jordan; Stella Almassian; David Conley; Bruce K Tan; Rakesh Chandra |
Related Documents
:
|
22152037 - Gray matter imaging in multiple sclerosis: what have we learned? 4063707 - Ct detection of necrotising enterocolitis. 23479497 - Shrink-induced sorting using integrated nanoscale magnetic traps. 1823167 - Bowel disease: prospective comparison of ct and 1.5-t pre- and postcontrast mr imaging ... 19039557 - [f-18]-fluorodeoxyglucose pet-ct of the normal prostate gland. 9201677 - A study of the effects of patient anxiety, perceptions and equipment on motion artifact... |
Publication Detail:
|
Type: Journal Article Date: 2011-07-29 |
Journal Detail:
|
Title: International forum of allergy & rhinology Volume: 1 ISSN: 2042-6984 ISO Abbreviation: Int Forum Allergy Rhinol Publication Date: 2011 Nov |
Date Detail:
|
Created Date: 2011-12-06 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101550261 Medline TA: Int Forum Allergy Rhinol Country: United States |
Other Details:
|
Languages: eng Pagination: 471-80 Citation Subset: IM |
Copyright Information:
|
Copyright © 2011 American Rhinologic Society-American Academy of Otolaryngic Allergy, LLC. |
Affiliation:
|
Department of Otolaryngology-Head and Neck Surgery, Northwestern Memorial Hospital, Northwestern University, Chicago, IL. randy.leung@utoronto.ca. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Unexpected consequences of transnasal balloon dilation of the maxillary ostium.
Next Document: Prospective evaluation of intraoperative computed tomography imaging for endoscopic sinonasal and sk...