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Cost analysis of vestibular schwannoma screening with contrast-enhanced magnetic resonance imaging in patients with asymmetrical hearing loss

Published online by Cambridge University Press:  14 September 2015

P Pan ,
J Huang ,
C Morioka ,
G Hathout  and
S M El-Saden
P Pan*
Affiliation:
Department of Radiology, UCLA Medical Center, Los Angeles, California, USA
J Huang
Affiliation:
Department of Radiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
C Morioka
Affiliation:
Department of Radiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
G Hathout
Affiliation:
Department of Radiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
S M El-Saden
Affiliation:
Department of Radiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
*
Address for correspondence: Dr Patrick Pan, Department of Radiology, UCLA Medical Center, 757 Westwood Blvd, Los Angeles, CA 90095, USA E-mail: ppan@mednet.ucla.edu
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Abstract

Background:

Vestibular schwannomas are a rare cause of asymmetrical hearing loss, and routine screening with magnetic resonance imaging can be costly. This paper reports results on vestibular schwannoma screening at our institution and compares the cost of screening to a utility of hearing benefit.

Method:

All screening examinations with magnetic resonance imaging performed for asymmetrical hearing loss between 2006 and 2011 were retrospectively reviewed. The cost per new vestibular schwannoma diagnosis was calculated. The cost per patient for those who benefitted from intervention was estimated based on rates of hearing preservation reported in the literature.

Results:

Forty-five (4.3 per cent) of 1050 screening examinations with magnetic resonance imaging performed for asymmetrical hearing loss were positive for vestibular schwannoma, and the cost per new diagnosis was $11 436. The estimated screening cost per patient for those who benefitted from surgery or radiation was $147 030, while US federal compensation for unilateral hearing loss was $44 888.

Conclusion:

Although we achieved a lower screening cost per new diagnosis than reported in the current literature, there remains disparity between the screening cost per benefitted patient and the ‘benefit’ of hearing.

Keywords

Vestibular SchwannomaScreeningMagnetic Resonance ImagingHearing LossCost Analysis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 1 , January 2016 , pp. 21 - 24
Copyright
Copyright © JLO (1984) Limited 2015 

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