TY - JOUR
T1 - Auditory brainstem response – a valid and cost-effective screening tool for vestibular schwannoma?
AU - Rafique, Irfan
AU - Wennervaldt, Kasper
AU - Melchiors, Jacob
AU - Caye-Thomasen, Per
PY - 2016
Y1 - 2016
N2 - Abstract: Conclusion: Contemporary auditory brainstem response (ABR) is not valid as a screening tool for VS, when considering the sensitivity of 80%, the specificity of 77%, and the positive predictive value of 3.4%, MRI screening is superior to ABR in Denmark when considering cost-effectiveness. Objectives: The aim of this study is to assess the sensitivity, specificity, and cost-effectiveness of ABR vs MRI, when screening for VS in a clinical setting. Method: Data was collected on all patients subjected to an ABR during a 3-year period (2005–2008) at a tertiary referral center. The data were compared to results of MRI and with data from The Danish National VS Database. In total, 1447 adults underwent ABR, of whom 349 were referred for a subsequent MRI. Sensitivity and specificity were calculated. To assess the cost-effectiveness of ABR vs MRI, procedure costs for ABR and MRI were retrieved from the National Board of Health. Results: Twelve (3.4%) of 349 patients were diagnosed with a VS. Of the 1098 patients not referred for MRI, three (0.3%) were later diagnosed with a VS. The sensitivity and specificity of ABR in diagnosing a VS were 80% and 77%, respectively. Procedure costs were 326 EURO for the ABR and 319 EURO for the MRI.
AB - Abstract: Conclusion: Contemporary auditory brainstem response (ABR) is not valid as a screening tool for VS, when considering the sensitivity of 80%, the specificity of 77%, and the positive predictive value of 3.4%, MRI screening is superior to ABR in Denmark when considering cost-effectiveness. Objectives: The aim of this study is to assess the sensitivity, specificity, and cost-effectiveness of ABR vs MRI, when screening for VS in a clinical setting. Method: Data was collected on all patients subjected to an ABR during a 3-year period (2005–2008) at a tertiary referral center. The data were compared to results of MRI and with data from The Danish National VS Database. In total, 1447 adults underwent ABR, of whom 349 were referred for a subsequent MRI. Sensitivity and specificity were calculated. To assess the cost-effectiveness of ABR vs MRI, procedure costs for ABR and MRI were retrieved from the National Board of Health. Results: Twelve (3.4%) of 349 patients were diagnosed with a VS. Of the 1098 patients not referred for MRI, three (0.3%) were later diagnosed with a VS. The sensitivity and specificity of ABR in diagnosing a VS were 80% and 77%, respectively. Procedure costs were 326 EURO for the ABR and 319 EURO for the MRI.
KW - Auditory brainstem response
KW - magnetic resonance scanning
KW - sensitivity
KW - vestibular schwannoma
U2 - 10.3109/00016489.2016.1157726
DO - 10.3109/00016489.2016.1157726
M3 - Journal article
C2 - 27045378
AN - SCOPUS:84962339931
SN - 0001-6489
VL - 136
SP - 660
EP - 662
JO - Acta Oto-Laryngologica
JF - Acta Oto-Laryngologica
IS - 7
ER -