Acoustic Neuroma - Otolaryngology - Lecture Slides, Slides of Otorhinolaryngology

Download Acoustic Neuroma - Otolaryngology - Lecture Slides and more Slides Otorhinolaryngology in PDF only on Docsity! Acoustic Neuroma • 12 per million per year • MRI can detect tumors as small as 3mm • Gold standard for diagnosis is MRI of IAC’s with gadolinium • Test cost at this institution is $3200 Docsity.com Acoustic Neuroma • ABR – Alternative to MRI for diagnosis – MRI generally 5 times more expensive than ABR – Decreased sensitivity – Cost at this institution is $500 Docsity.com Acoustic Neuroma • Used probability of acoustic in each group as (30%, 5%, 1%) • Sensitivity of detecting tumors with ABR based on size (100% large, 93% medium, 82% small) • Used PPV of 12% in ABR Docsity.com Acoustic Neuroma • Calculated cost of MRI for patients in each group • Calculated cost of ABR, and MRI for all ABR’s suggestive of acoustic neuroma • Calculated cost difference of two groups based on risk from history and physical • Calculated number acoustic neuromas missed if first screened with ABR Docsity.com Acoustic Neuroma • High risk - $40,000, no missed tumors • Intermediate risk - $900,000, clinician would miss 4 tumors in 900 patients screened • Low risk – $1.7 million, 1 tumor missed out of 1600 screened • Authors recommended clinical decision making with consideration of cost savings in intermediate to low risk groups Docsity.com