Cost-effectiveness of the diagnostic evaluation of vertigo.
OBJECTIVE
To evaluate the cost-effectiveness of several diagnostic tests used in the evaluation of vertigo.


METHODS
Cost-effectiveness analysis, using data from retrospective case review.


METHODS
Charts and test results were reviewed from 192 outpatients seen in an academic tertiary referral center for evaluation of vertigo. Cost-effectiveness analysis was performed using decision analysis software, data from office and hospital charges, and expert-based estimations of the utility of different test outcomes. Sensitivity analysis was performed using standard algorithms and wide variable ranges.


RESULTS
We found that audiologic testing, posturography, and electronystagmography were the most cost-effective tests, and that magnetic resonance imaging and blood tests had the lowest cost-effectiveness. The analysis was sensitive to the effects of financial costs of tests but, with a few exceptions, was typically not sensitive to the utility of test outcomes or the distribution of test results.


CONCLUSIONS
The use of cost-effectiveness analysis, the estimation of utility of test outcomes, and techniques of sensitivity analysis should help guide the clinician's decision making on appropriate testing for patients with vertigo.
Stewart
M G
MG
The Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas 77030, USA.
Chen
A Y
AY
Wyatt
J R
JR
Favrot
S
S
Beinart
S
S
Coker
N J
NJ
Jenkins
H A
HA
D001301:Audiometry, Pure-Tone; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D004584:Electronystagmography / Q000379:methods; D017048:Health Care Costs; D006801:Humans; D011187:Posture; D012189:Retrospective Studies; D014717:Vertigo / Q000175:diagnosis* / Q000191:economics*