Knaus W A, Davis D O
J Comput Assist Tomogr. 1978 Apr;2(2):209-14. doi: 10.1097/00004728-197804000-00015.
This study prospectively surveyed the utilization of cranial computed tomography (CCT) at The George Washington University Hospital over a 12-month period. Of 3,070 CCT scans studied, 1,098 (35%) resulted in a positive clinically important diagnosis for an overall case finding cost of $800. Within each of 25 individual indications for scanning, classified on the basis of the patient's most specific sign or symptom, case finding costs varied from a low of $411 for patients in coma to $3,500 for patients with headaches as their only indication for CT scanning. Within two diagnostic categories, malignant brain tumors and cerebral aneurysms, there was significant agreement (p less than 0.001) between the prescanning diagnosis and the result on CCT. Overall there was also close agreement (correlation coefficient = 0.706) between the rank listing of the 25 indications for scanning compiled prior to CCT with that obtained after the scanning results were known.
本研究前瞻性地调查了乔治华盛顿大学医院在12个月期间头颅计算机断层扫描（CCT）的使用情况。在研究的3070次CCT扫描中，1098次（35%）得出了具有临床重要意义的阳性诊断，总体病例发现成本为800美元。在根据患者最具体的体征或症状分类的25种个体扫描指征中，病例发现成本各不相同，从昏迷患者的411美元到以头痛为CT扫描唯一指征患者的3500美元不等。在两个诊断类别，即恶性脑肿瘤和脑动脉瘤中，扫描前诊断与CCT结果之间存在显著一致性（p小于0.001）。总体而言，在CCT之前编制的25种扫描指征的排名列表与扫描结果已知后获得的排名列表之间也存在密切一致性（相关系数=0.706）。
