Vestibular schwannoma screening: closing the audit loop

Abstract

Completion of an audit loop assessing vestibular schwannoma screening practice in a sub-regional ENT centre shows good agreement between the guidelines given and indications used for selecting patients to undergo screening MRIg. The proportion of cerebellopontine angle tumours diagnosed is consistent with other reports from the United Kingdom. During the audit period the proportion of patients screened because of unilateral tinnitus increased, but not beyond a reasonable estimate of the proportion that could expect to be screened because of this symptom. There was a reduction in the number of inappropriate scan requests after introduction of a guideline reminder. During the initial period after introducing screening guidelines there is increased screening activity, but this plateaus at a steady level.

Incidence of vestibular schwannoma and incidental findings on the magnetic resonance imaging and computed tomography scans of patients from a direct referral audiology clinic

“…During the three and a half year study period, 396 scans were carried out and six cases of vestibular schwannoma were identified amongst patients seen in the direct referral audiology clinic. This represents a detection rate of 1.5 per cent, which is lower than the 3–5 per cent rate in the published literature 10 , 13 …”

Transforming management of patients undergoing splenectomy in an Irish teaching hospital

“…It was necessary to close the audit loop by re-evaluating our performance. Multiple studies have stressed the importance of closing the audit loop in achieving compliance with evidencebased guidelines [12][13][14][15][16][17].…”

Three‐Year Ear, Nose, and Throat Cross‐sectional Analysis of Audiometric Protocols for Magnetic Resonance Imaging Screening of Acoustic Tumors

“…Most studies have selectively collected cases and assigned control groups in quantifying the extent of interaural asymmetry. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] As a result, each audiometric protocol has claimed superiority of the diagnostic sensitivity and specificity of its own formula. Comparing the audiometric protocols applied to clinical cohorts can provide cumulative evidence of the actual and proportional clinical outcomes through the normal course of ENT, audiological, and MRI diagnostic operations.…”