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Laryngoscope. 1999 Apr;109(4):600-5.

Cost-effectiveness of the diagnostic evaluation of vertigo.

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  • 1The Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas 77030, USA.

Abstract

OBJECTIVE:

To evaluate the cost-effectiveness of several diagnostic tests used in the evaluation of vertigo.

STUDY DESIGN:

Cost-effectiveness analysis, using data from retrospective case review.

METHODS:

Charts and test results were reviewed from 192 outpatients seen in an academic tertiary referral center for evaluation of vertigo. Cost-effectiveness analysis was performed using decision analysis software, data from office and hospital charges, and expert-based estimations of the utility of different test outcomes. Sensitivity analysis was performed using standard algorithms and wide variable ranges.

RESULTS:

We found that audiologic testing, posturography, and electronystagmography were the most cost-effective tests, and that magnetic resonance imaging and blood tests had the lowest cost-effectiveness. The analysis was sensitive to the effects of financial costs of tests but, with a few exceptions, was typically not sensitive to the utility of test outcomes or the distribution of test results.

CONCLUSIONS:

The use of cost-effectiveness analysis, the estimation of utility of test outcomes, and techniques of sensitivity analysis should help guide the clinician's decision making on appropriate testing for patients with vertigo.

PMID:
10201748
[PubMed - indexed for MEDLINE]
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