Comparison between radiography and magnetic resonance imaging for the detection of sacroiliitis in the initial diagnosis of axial spondyloarthritis: a cost-effectiveness study

Gorelik, Natalia; Tamizuddin, Farah; Rodrigues, Tatiane Cantarelli; Beltrán, Luis; Malik, Fardina; Reddy, Soumya; Koo, James; Subhas, Naveen; Gyftopoulos, Soterios

doi:10.1007/s00256-020-03444-6

Cited by 7 publications

(8 citation statements)

References 31 publications

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“…Most studies were performed in the United States (n = 15, 83.3%), two were from Canada and one was from Australia. The clinical setting of included studies was distributed across primary care [18][19][20][21][22], outpatient orthopaedic clinics [21,[23][24][25][26][27][28][29], and emergency departments [30][31][32][33][34], with one study set in a rheumatology clinic [35].…”

Section: Resultsmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) was most commonly investigated (n = 13, 72.2%), including three studies for back complaints [18,25,35], three studies for neck complaints [31,33,34], and seven studies for knee [21,23,27] and shoulder [24,26,28,29] complaints. Computed tomography and x-ray were only investigated in studies of back and neck complaints [18-20, 22, 25, 30, 32, 35].…”

Section: Resultsmentioning

confidence: 99%

“…Reporting of methods was poor in some studies, which limits replication and the generalisability of research findings (Table 2). Issues included absence of the reporting model structure (two studies [20,35]), time horizon (four studies [19,[25][26][27]), discount rate (six studies [19,21,[25][26][27]31]), and cycle length for Markov models (three of four Markov models [23,33,34]).…”

Section: Summary Of Study Methodsmentioning

confidence: 99%

“…Six studies conducted their analysis from a societal perspective [21,27,30,[32][33][34], four of which investigated the cost-effectiveness of diagnostic imaging for traumatic cervical spine injuries [30,[32][33][34]. Nine considered a healthcare perspective with some slight variations applied [18, 19, 23, 24, 27-29, 31, 35].…”

Section: Summary Of Study Methodsmentioning

confidence: 99%

“…There were also a wide range of time horizons employed when stated. A lifetime horizon was employed by five studies [30][31][32][33][34], all of which investigated the cost-effectiveness of diagnostic imaging for traumatic cervical spine injuries. Time horizons for the remaining studies ranged from 8 weeks to 10 years.…”

Section: Summary Of Study Methodsmentioning

confidence: 99%

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Use of Decision-Analytic Modelling to Assess the Cost-Effectiveness of Diagnostic Imaging of the Spine, Shoulder, and Knee: A Scoping Review

Docking

Dunstan

Ademi

et al. 2023

Appl Health Econ Health Policy

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Background Limited evidence is available on the cost-effectiveness of diagnostic imaging for back, neck, knee, and shoulder complaints. Decision analytic modelling may be an appropriate method to synthesise evidence from multiple sources, and overcomes issues with trial-based economic evaluations. Objective The aim was to describe the reporting of methods and objectives utilised in existing decision analytic modelling studies that assess the cost-effectiveness of diagnostic imaging for back, neck, knee, and shoulder complaints. Methods Decision analytic modelling studies investigating the use of any imaging modality for people of any age with back, neck, knee, or shoulder complaints were included. No restrictions on comparators were applied, and included studies were required to estimate both costs and benefits. A systematic search (5 January 2023) of four databases was conducted with no date limits imposed. Methodological and knowledge gaps were identified through a narrative summary. Results Eighteen studies were included. Methodological issues were identified relating to the poor reporting of methods, and measures of effectiveness did not incorporate changes in quantity and/or quality of life (cost-utility analysis in only ten of 18 studies). Included studies, particularly those investigating back or neck complaints, focused on conditions that were of low prevalence but have a serious impact on health (i.e. cervical spine trauma, cancer-related back pain). Conclusions Future models should pay particular attention to the identified methodological and knowledge gaps. Investment in the health technology assessment of these commonly utilised diagnostic imaging services is needed to justify the current level of utilisation and ensure that these services represent value for money. Key Points for Decision MakersThere is a paucity of high-quality modelling studies investigating the cost-effectiveness of diagnostic imaging for common musculoskeletal complaints despite its widespread use.There are few high-quality modelling studies that adhere to modelling guidelines, limiting our understanding of whether diagnostic imaging for back, neck, knee, and shoulder complaints represent value for money.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Summary Of Study Methodsmentioning

confidence: 99%

Section: Summary Of Study Methodsmentioning

confidence: 99%

Section: Summary Of Study Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Use of Decision-Analytic Modelling to Assess the Cost-Effectiveness of Diagnostic Imaging of the Spine, Shoulder, and Knee: A Scoping Review

Docking

Dunstan

Ademi

et al. 2023

Appl Health Econ Health Policy

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Regional Differences in Diagnosis Journey and Healthcare Utilization: Results from the International Map of Axial Spondyloarthritis (IMAS)

Garrido-Cumbrera,

Poddubnyy,

Sommerfleck

et al. 2024

Rheumatol Ther

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Introduction To assess differences in the diagnosis journey and access to care in a large sample of patients with axial spondyloarthritis (axSpA) from around the world, included in the International Map of Axial Spondyloarthritis (IMAS). Methods IMAS was a cross-sectional online survey (2017–2022) of 5557 unselected patients with axSpA from 27 countries. Across five worldwide geographic regions, the patient journey until diagnosis and healthcare utilization in the last 12 months prior to survey were evaluated. Univariable and multivariable linear regression was used to analyze factors associated with higher healthcare utilization. Results Of 5557 participants in IMAS, the diagnosis took an average of 7.4 years, requiring more than two visits to HCPs (77.7% general practitioner and 51.3% rheumatologist), and more than two diagnostic tests [67.5% performed human leukocyte antigen B27 (HLA-B27), 64.2% x-ray, and 59.1% magnetic resonance imaging (MRI) scans]. North America and Europe were the regions with the highest number of healthcare professional (HCP) visits for diagnosis, while the lowest number of visits was in the Asian region. In the previous 12 months, 94.9% ( n = 5272) used at least one healthcare resource, with an average of 29 uses per year. The regions with the highest healthcare utilization were Latin America, Europe, and North America. In the multiple linear regression, factors associated with higher number of healthcare utilization were younger age (b = – 0.311), female gender (b = 7.736), higher disease activity (b = 1.461), poorer mental health (b = 0.624), greater functional limitation (b = 0.300), greater spinal stiffness (b = 1.527), and longer diagnostic delay (b = 0.104). Conclusion The diagnosis of axSpA usually takes more than two visits to HCPs and at least 7 years. After diagnosis, axSpA is associated with frequent healthcare resource use. Younger age, female gender, higher disease activity, poorer mental health, greater functional limitation, greater spinal stiffness, and longer diagnostic delay are associated with higher healthcare utilization. Europe and North America use more HCP visits and diagnostic tests before and after diagnosis than the other regions.

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The value of correctly diagnosing axial spondyloarthritis for patients and society

Webers

Grimm

Tubergen

et al. 2023

Seminars in Arthritis and Rheumatism

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Comparison between radiography and magnetic resonance imaging for the detection of sacroiliitis in the initial diagnosis of axial spondyloarthritis: a cost-effectiveness study

Cited by 7 publications

References 31 publications

Use of Decision-Analytic Modelling to Assess the Cost-Effectiveness of Diagnostic Imaging of the Spine, Shoulder, and Knee: A Scoping Review

Use of Decision-Analytic Modelling to Assess the Cost-Effectiveness of Diagnostic Imaging of the Spine, Shoulder, and Knee: A Scoping Review

Regional Differences in Diagnosis Journey and Healthcare Utilization: Results from the International Map of Axial Spondyloarthritis (IMAS)

The value of correctly diagnosing axial spondyloarthritis for patients and society

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