title: Cost analysis of vestibular schwannoma screening with contrast-enhanced magnetic resonance imaging in patients with asymmetrical hearing loss.
abstract: BACKGROUND
  Vestibular schwannomas are a rare cause of asymmetrical hearing loss, and routine screening with magnetic resonance imaging can be costly. This paper reports results on vestibular schwannoma screening at our institution and compares the cost of screening to a utility of hearing benefit.
  
  
  METHODS
  All screening examinations with magnetic resonance imaging performed for asymmetrical hearing loss between 2006 and 2011 were retrospectively reviewed. The cost per new vestibular schwannoma diagnosis was calculated. The cost per patient for those who benefitted from intervention was estimated based on rates of hearing preservation reported in the literature.
  
  
  RESULTS
  Forty-five (4.3 per cent) of 1050 screening examinations with magnetic resonance imaging performed for asymmetrical hearing loss were positive for vestibular schwannoma, and the cost per new diagnosis was $11,436. The estimated screening cost per patient for those who benefitted from surgery or radiation was $147,030, while US federal compensation for unilateral hearing loss was $44,888.
  
  
  CONCLUSIONS
  Although we achieved a lower screening cost per new diagnosis than reported in the current literature, there remains disparity between the screening cost per benefitted patient and the 'benefit' of hearing.
authors.affiliation: Department of Radiology,UCLA Medical Center,Los Angeles,California,USA.
authors.forename: P
authors.initials: P
authors.lastname: Pan
authors.affiliation: Department of Radiology,Veterans Affairs Greater Los Angeles Healthcare System,Los Angeles,California,USA.
authors.forename: J
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Radiology,Veterans Affairs Greater Los Angeles Healthcare System,Los Angeles,California,USA.
authors.forename: C
authors.initials: C
authors.lastname: Morioka
authors.affiliation: Department of Radiology,Veterans Affairs Greater Los Angeles Healthcare System,Los Angeles,California,USA.
authors.forename: G
authors.initials: G
authors.lastname: Hathout
authors.affiliation: Department of Radiology,Veterans Affairs Greater Los Angeles Healthcare System,Los Angeles,California,USA.
authors.forename: S M
authors.initials: SM
authors.lastname: El-Saden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000191:economics; D003365:Costs and Cost Analysis; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods; D034381:Hearing Loss / Q000191:economics / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications / Q000175:diagnosis* / Q000191:economics; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media
keywords: Cost Analysis; Hearing Loss; Magnetic Resonance Imaging; Screening; Vestibular Schwannoma