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Ultrasound For Appendicitis Could Cut Costs

April 21, 2011
Written by: , Filed in: Abdominal Imaging, Diagnostic Imaging
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Ultrasound continues to gather momentum as a first-choice imaging modality. New research from Thomas Jefferson University in Philadelphia suggests that using ultrasound instead of CT for preliminary evaluations of patients suffering appendicitis symptoms would save money.

A lot of money.

ImagingBiz reports that the researchers estimate such a switch would reduce U.S. health-care expenditures by $1.2 billion annually. Oh, and prevent 174 cancer deaths a year too because of reduced radiation exposure from CT.

The proposed protocol would involve sending potential appendicitis patients with positive ultrasound results directly to surgery. Those with negative results would get a follow-up CT scan. Levon Nazarian, MD, of the university’s radiology department presented the research results at last week’s American Institute of Ultrasound in Medicine annual convention in New York.

The researchers estimated that the positive predictive value for appendicitis was 91 percent for ultrasound and 92.5 percent for CT.

Dr. Nazarian, who presented the results on behalf of lead researcher Laurence Parker, PhD, said, “There was a ratio of one abdominal and one pelvic CT for every case of appendicitis diagnosed in this country.” Regarding appendicitis patients, he added:

Less than 4 percent receive an ultrasound. The cost differences between CT and a limited abdominal ultrasound average $458.53.

The researchers examined federal Centers for Medicare & Medicaid Services records for 2007 to determine the annual number and costs of ultrasound and CT scans performed to evaluate appendicitis symptoms. To determine the U.S. incidence of appendicitis and abdominal pain, they checked national hospital discharge statistics.

To assess the value of ultrasound and CT for evaluating patients with appendicitis symptoms, the team performed a meta-analysis of 74 recent research studies. It obtained radiation exposure data from 30 consecutive patients’ abdominal and pelvic CT scans at Thomas Jefferson University Hospitals. And it extrapolated from the Biological Effects of Ionizing Radiation VII model to estimate the number of extra cancer deaths from CT appendicitis evaluation.

Related seminar: Imaging Advances: Abdominal, Thoracic, Skeletal


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One Response to “Ultrasound For Appendicitis Could Cut Costs”

  1. Carlos on April 22nd, 2011 at 11:48 am

    In performing a cost benefit analysis, it appears that authors assume that US and CT have identical sensitivity and specificity. In addition, the authors assume that the sensitivity and specificity for alternative diagnoses is identical. Any cost benefit analysis must consider factors.

    CT can more conclusively identify a normal appendix. This is always useful clinical information.