Are CT Scans Overutilized in the Workup of Vertebral Compression Fractures?

McGowan, Shane; Ramski, David E.; Homcha, Brittany; Sokunbi, Gbolabo

doi:10.1097/bsd.0000000000000816

Cited by 7 publications

(2 citation statements)

References 13 publications

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“…Based on the reported cost per examination of the included studies an overview per modality is presented in Table 3 , both in terms of overall cost per modality and with examples of specific patient groups. Costs vary based on cost level in different countries and imaging techniques, for example, in MRI number of sequences and use of contrast media [ 22 , 24 , 26 – 34 , 37 – 44 , 46 , 47 , 50 – 53 , 55 – 58 , 60 , 61 , 63 – 75 , 77 – 91 , 95 , 96 , 99 , 102 , 104 , 106 – 110 , 112 – 114 , 117 – 126 ].…”

Section: Resultsmentioning

confidence: 99%

“…For CT and MRI, oncology, orthopedic, cardiovascular, and neurology patients were the dominating patient groups included, with routine examinations or imaging non-compliant with guidelines dominating the findings [ 55 – 58 , 60 , 61 , 63 – 65 , 74 , 75 , 77 – 88 , 91 , 95 , 96 , 99 , 102 , 104 , 106 – 110 , 112 – 114 , 117 – 126 ].…”

Section: Resultsmentioning

confidence: 99%

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Cost of Low-Value Imaging Worldwide: A Systematic Review

Kjelle,

Brandsæter,

Andersen

et al. 2024

Appl Health Econ Health Policy

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Background and Objective Imaging with low or no benefit for the patient undermines the quality of care and amounts to vast opportunity costs. More than 3.6 billion imaging examinations are performed annually, and about 20–50% of these are of low value. This study aimed to synthesize knowledge of the costs of low-value imaging worldwide. Methods This systematic review was based on the PRISMA statement. The database search was developed in Medline and further adapted to Embase-Ovid, Cochrane Library, and Scopus. Primary empirical studies assessing the costs of low-value diagnostic imaging were included if published between 2012 and March 2022. Studies designed as randomized controlled trials, non-randomized trials, cohort studies, cross-sectional studies, descriptive studies, cost analysis, cost-effectiveness analysis, and mixed-methods studies were eligible. The analysis was descriptive. Results Of 5,567 records identified, 106 were included. Most of the studies included were conducted in the USA ( n = 76), and a hospital or medical center was the most common setting ( n = 82). Thirty-eight of the included studies calculated the costs of multiple imaging modalities; in studies with only one imaging modality included, conventional radiography was the most common ( n = 32). Aggregated costs for low-value examinations amounts to billions of dollars per year globally. Initiatives to reduce low-value imaging may reduce costs by up to 95% without harming patients. Conclusions This study is the first systematic review of the cost of low-value imaging worldwide, documenting a high potential for cost reduction. Given the universal challenges with resource allocation, the large amount used for low-value imaging represents a vast opportunity cost and offers great potential to improve the quality and efficiency of care. Supplementary Information The online version contains supplementary material available at 10.1007/s40258-024-00876-2.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cost of Low-Value Imaging Worldwide: A Systematic Review

Kjelle,

Brandsæter,

Andersen

et al. 2024

Appl Health Econ Health Policy

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Osteoporotic Vertebral Fractures

Bassani,

Galich,

Petracchi

2024

Orthopaedics and Trauma

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Disparities in management of symptomatic osteoporotic vertebral compression fractures: a nationwide multidisciplinary survey

Weber,

Vercoulen,

Jacobs

et al. 2024

Arch Osteoporos

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Summary This nationwide multidisciplinary survey found dissatisfaction among physicians with current osteoporotic vertebral compression fracture care, revealing significant disparities in diagnosis, treatment, and follow-up practices. Issues include poor communication and differing guidelines. Improving interdisciplinary collaboration and standardized care strategies is essential for better patient outcomes. Purpose This survey aims to assess current preferred care practices for symptomatic osteoporotic vertebral compression fractures (OVCF) in the Netherlands, focusing on guideline adherence, identifying knowledge gaps, and clarifying consensus and collaboration across medical disciplines in OVCF treatment. Methods This cross-sectional study was conducted via Qualtrics (Provo, UT) using a self-administered online survey distributed to 238 general practitioners and physicians in orthopedics, traumatology, internal medicine, rheumatology, and geriatrics working at 51 hospitals in the Netherlands. The survey, conducted in Dutch, included 36 multiple-choice and two open questions and was accessible via an anonymous email link or QR code. General practitioners received additional questions specific to their role. Data was anonymized, stored securely, and analyzed using descriptive statistics in Microsoft Excel and SPSS (Version 24). Open-ended responses were coded and categorized. The survey was conducted prior to the publication of the updated Federation of Medical Specialists guidelines in 2024. Results Physicians across various disciplines uniformly expressed dissatisfaction with current OVCF care. The survey highlighted significant disparities in diagnosis, treatment, and follow-up practices. A lack of communication between primary and secondary care providers and differing guidelines further complicate OVCF management. These issues point to considerable variation in clinical practice and gaps in interdisciplinary collaboration. Conclusion Addressing the identified issues requires fostering interdisciplinary collaboration and creating cohesive care strategies. Ensuring access to diagnostic resources in both primary and secondary care and establishing coordinated care models promises more structured and standardized treatment. These steps are crucial for enhancing patient outcomes in OVCF management.

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Are CT Scans Overutilized in the Workup of Vertebral Compression Fractures?

Cited by 7 publications

References 13 publications

Cost of Low-Value Imaging Worldwide: A Systematic Review

Cost of Low-Value Imaging Worldwide: A Systematic Review

Osteoporotic Vertebral Fractures

Disparities in management of symptomatic osteoporotic vertebral compression fractures: a nationwide multidisciplinary survey

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