Advanced

AJNR - American Journal of Neuroradiology

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Seidenwurm, D. J. Articles by Breslau, J. Search for Related Content PubMed PubMed Citation Articles by Seidenwurm, D. J. Articles by Breslau, J.

American Journal of Neuroradiology 21:426-433 (2 2000)
© 2000 American Society of Neuroradiology

ARTICLE

Cost Utility Analysis of Radiographic Screening for an Orbital Foreign Body before MR Imaging

David J. Seidenwurm^,a, Charles H. McDonnell III^a, Narasimhachari Raghavan^a and Jonathan Breslau^a

^a From Radiological Associates of Sacramento Medical Group, Inc, 1800 I St, Sacramento, CA 95814.

BACKGROUND AND PURPOSE: Our purpose was to evaluate the cost-effectiveness of clinical versus radiographic screening for an orbital foreign body before MR imaging.

METHODS: Costs of screening were determined on the basis of published reports, disability rating guides, and a practice survey. Base case estimates were derived from published guidelines. A single-state change model was constructed using social cost as the unit of analysis. Sensitivity analysis was performed for each variable. The benefit of screening was avoidance of immediate, permanent, nonameliorable, unilateral blindness.

RESULTS: Using base case estimates and a discount rate of zero, we calculated the cost of the current guideline as $328,580 per quality-adjusted life-year saved. Sensitivity analysis identified screening cost as a critical variable. Discount rates and effectiveness of foreign body removal also were found to be important factors. Probability of injury and prevalence of foreign body may impact the analysis.

CONCLUSION: Clinical screening before radiography increases the cost-effectiveness of foreign body screening by an order of magnitude, assuming base case ocular foreign body removal rates. Asking the patient "Did a doctor get it all out?" serves this purpose. Occupational history by itself is not sufficient to mandate radiographic orbital screening. Current practice guidelines for foreign body screening should be altered.

This article has been cited by other articles:

				E. Kanal, A. J. Barkovich, C. Bell, J. P. Borgstede, W. G. Bradley Jr., J. W. Froelich, T. Gilk, J. R. Gimbel, J. Gosbee, E. Kuhni-Kaminski, et al. ACR Guidance Document for Safe MR Practices: 2007 Am. J. Roentgenol., June 1, 2007; 188(6): 1447 - 1474. [Full Text] [PDF]

				F. G. Shellock and J. V. Crues MR Procedures: Biologic Effects, Safety, and Patient Care Radiology, September 1, 2004; 232(3): 635 - 652. [Abstract] [Full Text] [PDF]

				E. Kanal, J. P. Borgstede, A. J. Barkovich, C. Bell, W. G. Bradley, J. P. Felmlee, J. W. Froelich, E. M. Kaminski, E. K. Keeler, J. W. Lester, et al. American College of Radiology White Paper on MR Safety Am. J. Roentgenol., June 1, 2002; 178(6): 1335 - 1347. [Full Text] [PDF]