Cost-Effectiveness of Diagnostic Strategies for Suspected Scaphoid Fractures

Journal of Orthopaedic Trauma
Zhong-Gang YinKe-Tong Gong

Abstract

The aim of this study was to assess the cost effectiveness of multiple competing diagnostic strategies for suspected scaphoid fractures. With published data, the authors created a decision-tree model simulating the diagnosis of suspected scaphoid fractures. Clinical outcomes, costs, and cost effectiveness of immediate computed tomography (CT), day 3 magnetic resonance imaging (MRI), day 3 bone scan, week 2 radiographs alone, week 2 radiographs-CT, week 2 radiographs-MRI, week 2 radiographs-bone scan, and immediate MRI were evaluated. The primary clinical outcome was the detection of scaphoid fractures. The authors adopted societal perspective, including both the costs of healthcare and the cost of lost productivity. The incremental cost-effectiveness ratio (ICER), which expresses the incremental cost per incremental scaphoid fracture detected using a strategy, was calculated to compare these diagnostic strategies. Base case analysis, 1-way sensitivity analyses, and "worst case scenario" and "best case scenario" sensitivity analyses were performed. In the base case, the average cost per scaphoid fracture detected with immediate CT was $2553. The ICER of immediate MRI and day 3 MRI compared with immediate CT was $7483 and $32,000...Continue Reading

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Citations

Jul 27, 2017·Plastic and Reconstructive Surgery·Jason H KoWarren C Hammert
Aug 31, 2018·Journal of Medical Radiation Sciences·Asanka R WijetungaBruno Giuffre
Nov 9, 2018·Skeletal Radiology·Monique BrinkMathias Prokop
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Feb 8, 2019·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Kimberly H McVeighJames C Braxton

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