title: Choosing Wisely: highest-cost tests in outpatient neurology.
abstract: Identifying the tests/procedures ordered by neurologists that contribute most to health care expenditures is a critical step in the process of creating the neurology top 5 list for the Choosing Wisely initiative. Using data from the 2007-2010 National Ambulatory Care Medical Survey, we found that $13.3 billion (95% confidence interval = $10.1-$16.5 billion) was spent on tests ordered at neurologist visits. The tests/procedures with the highest expenditures were magnetic resonance imaging (MRI; 51% of total expenditures; $7.5 billion), electromyography (EMG; 20% of expenditures; $2.6 billion), and electroencephalography (EEG; 8% of expenditures; $1.1 billion). MRI, EMG, and EEG should receive close scrutiny in the development of the neurology top 5 list.
authors.affiliation: Department of Veterans Affairs, VA Center for Clinical Management and Research, Ann Arbor, VA, USA. jamesbur@umich.edu
authors.forename: James F
authors.initials: JF
authors.lastname: Burke
authors.forename: Lesli E
authors.initials: LE
authors.lastname: Skolarus
authors.forename: Brian C
authors.initials: BC
authors.lastname: Callaghan
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Kerber
mesh_terms: D004569:Electroencephalography; D004576:Electromyography; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D008279:Magnetic Resonance Imaging; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology; D009462:Neurology; D010045:Outpatients