Cost and radiation savings of partial substitution of ultrasound for CT in appendicitis evaluation: A national projection

American Journal of Roentgenology

Volumn 202, Issue 1, 2014, Pages 124-135

  Parker, Laurence ^a   Nazarian, Levon N ^a   Gingold, Eric L ^a   Palit, Charles D ^b   Hoey, Courtney L ^a   Frangos, Andrea J ^a  

^a THOMAS JEFFERSON UNIVERSITY   (United States)

^b UNIVERSITY OF WISCONSIN MADISON   (United States)

Author keywords

Appendicitis evaluation; Comparative effectiveness research; CT; Health economics; Radiation exposure; Ultrasound

Indexed keywords

ADULT; APPENDECTOMY; APPENDICITIS; ARTICLE; CANCER MORTALITY; CHILD; CLINICAL EFFECTIVENESS; COMPARATIVE STUDY; COMPUTER ASSISTED TOMOGRAPHY; CONTROLLED STUDY; COST BENEFIT ANALYSIS; COST CONTROL; DIAGNOSTIC TEST ACCURACY STUDY; ECHOGRAPHY; FALSE NEGATIVE RESULT; FALSE POSITIVE RESULT; FEMALE; HEALTH CARE COST; HEALTH SURVEY; HOSPITAL DISCHARGE; HOSPITAL INFORMATION SYSTEM; HUMAN; IONIZING RADIATION; MALE; MEDICAID; MEDICARE; META ANALYSIS; POPULATION RESEARCH; PREDICTIVE VALUE; PRIORITY JOURNAL; RADIATION EXPOSURE; RADIATION PROTECTION; SENSITIVITY ANALYSIS; SENSITIVITY AND SPECIFICITY; SURGICAL MORTALITY; UNITED STATES;

EID: 84891916018     PISSN: 0361803X     EISSN: 15463141     Source Type: Journal    
DOI: 10.2214/AJR.12.9642     Document Type: Article

References (33)

1. MedPAC website. MedPAC recommendations on imaging services, statement of Mark E. Miller, Ph.D. before the Subcommittee on Health, Committee on Ways and Means, U.S. House of Representatives, March 17, 2005. http://waysandmeans.house. gov/media/transcript/10123.html#miller Accessed October 9, 2013
2. Maitino AJ, Levin DC, Parker L, Rao VM, Sunshine JH. Nationwide trends in rates of utilization of noninvasive diagnostic imaging among the Medicare population between 1993 and 1999. Radiology 2003; 227:113-117
3. Government Accountability Office (GAO). Report to Congressional requesters: Medicare Part B imaging services - rapid spending growth and shift to physician offices indicate need for CMS to consider additional management practices. Washington, DC: GAO, June 2008: report GAO-08-452
4. Government Printing Office website. Deficit Reduction Act of 2005: Public Law 109-171, February 8, 2006. frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi? dbname=109-cong-public-laws&docid=f:publ171.109.pdf. Accessed September 5, 2013
5. de Jesus JO, Parker L, Frangos AJ, Nazarian LN. Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. AJR 2009; 192:1701-1707
6. Parker L, Nazarian LN, Carrino JA, et al. Musculoskeletal imaging: Medicare use, costs, and potential for cost substitution. J Am Coll Radiol 2008; 5:182-188
7. Parks NA, Schroeppel TJ. Update on imaging for acute appendicitis. Surg Clin North Am 2011; 91:141-154
8. SCOAP Collaborative; Cuschieri J, Florence M, Flum DR, et al. Negative appendectomy and imaging accuracy in the Washington State Surgical Care and Outcomes Assessment Program. Ann Surg 2008; 248:557-563
9. Raja AS, Wright C, Sodickson AD, et al. Negative appendectomy rate in the era of CT: an 18-year perspective. Radiology 2010; 256:460-465
10. Doria AS. Optimizing the role of imaging in appendicitis. Pediatr Radiol 2009; 39(suppl 2):S144-S148
11. Long SS, Long C, Lai H, Macura KJ. Imaging strategies for right lower quadrant pain in pregnancy. AJR 2011; 196:4-12
12. Toorenvliet BR, Wiersma F, Bakker RF, Merkus JW, Breslau PJ, Hamming JF. Routine ultrasound and limited computed tomography for the diagnosis of acute appendicitis. World J Surg 2010; 34:2278-2285
13. Krishnamoorthi R, Ramarajan N, Wang NE, et al. Effectiveness of a staged US and CT protocol for the diagnosis of pediatric appendicitis: reducing radiation exposure in the age of ALARA. Radiology 201; 259:231-239
14. Agency for Healthcare Research and Quality website. What is comparative effectiveness research? www.effectivehealthcare.ahrq.gov/index.cfm/what-is- comparative-effectiveness-research1/. Accessed April 20, 2012
15. Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes, 3rd ed. New York, NY: Oxford University Press, 2005
16. Research Data Assistance Center (ResDAC) website. Find a CMS data file. http://www.resdac.org/cms-data Accessed October 1, 2013
17. DeFrances J, Williams SN, Golosinskiy A, Schwartzman A. National hospital discharge survey: 2007 summary. Natl Health Stat Rep 2010; 26:1-20, 24
18. Agency for Healthcare Research and Quality website. HCUPnet national and regional estimates on hospital use for all patients from the HCUP Nationwide Inpatient Sample. http://hcupnet.ahrq.gov/HCUPnet.jsp?Id= 8570EC6372CF783B&Form=MAINSEL&JS=Y&Action=%3E%3ENext%3E%3E&- MAINSEL=NationalStatistics. Accessed June 28, 2011
19. Arias E. United States life tables, 2006 (Tables 2 and 3). Centers for Disease Control and Prevention website. www.cdc.gov/nchs/data/nvsr/nvsr58/ nvsr58-21.pdf. Accessed June 28, 2011
20. American Medical Association (AMA). International classification of diseases, ninth revision, clinical modification (ICD-9-CM): physician 2007, vols. 1 and 2, 1st ed. Chicago, IL: AMA, 2007
21. American Medical Association (AMA). Current Procedural Terminology, 4th ed. Chicago, IL: AMA, 2007
22. National Center for Environmental Economics website. What value of statistical life does the EPA use? http://yosemite.epa.gov/ee/epa/eed.nsf/pages/ MortalityRiskValuation.html#whatisvsl. Accessed February 23, 2011
23. American Association of Physicists in Medicine (AAPM). The measurement, reporting, and management of radiation dose in CT: report of AAPM Task Group 23 of the Diagnostic Imaging Council CT Committee. College Park, MD: AAPM, 2007: AAPM report no. 96, equation 12
24. Division on Earth & Life Studies of the National Academies website. Report in brief: BEIR VII - health risks from exposure to low levels of ionizing radiation. http://dels.nas.edu/resources/static-assets/materials-based-on- reports/reports-in-brief/beir-vii-final.pdf. Accessed February 15, 2011
25. Committee to Assess Health Risks From Exposure to Low Levels of Ionizing Radiation, Board on Radiation Effects Research, Division of Earth & Life Studies, National Research Council of the National Academies. Health risks from exposure to low levels of ionizing radiation: BEIR VII Phase 2. Washington, DC: National Academies Press, 2006
26. Mettler FA, Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and nuclear medicine: a catalog. Radiology 2008; 248:254-263
27. American College of Radiology website. ACR Appropriateness Criteria: clinical condition - right lower quadrant pain, suspected appendicitis. www.acr.org/~/media/7425A3E08975451EAB571A316DB4CA1B.pdf. Published 1996. Reviewed 2010. Accessed May 8, 2013
28. Brenner DJ, Hall EJ. Computed tomography: an increasing source of radiation exposure. N Engl J Med 2007; 357:2277-2284
29. Baerlocher MO, Detsky AS. Discussing radiation risks associated with CT scans with patients. JAMA 2010; 304:2170-2171
30. Tubiana M, Feinendegen LE, Yang C, Kaminski J. The linear no-threshold relationship is inconsistent with radiation biologic and experimental data. Radiology 2009; 251:13-22
31. Doria AS, Moineddin R, Kellenberger CJ, et al. US or CT for diagnosis of appendicitis in children and adults? A meta-analysis. Radiology 2006; 241:83-94
32. Pickhardt PJ, Lawrence EM, Pooler BD, Bruce RJ. Diagnostic performance of multidetector computed tomography for suspected acute appendicitis. Ann Intern Med 2011; 154:789-796
33. Wan MJ, Krahn M, Ungar WJ, et al. Acute appendicitis in young children: cost-effectiveness of US versus CT in diagnosis - a Markov decision analytic model. Radiology 2009; 250:378-386