Murphy Mark R, Selesnick Samuel H
Department of Otorhinolaryngology, Weill College of Medicine of Cornell University, New York, New York 10021, USA.
Otolaryngol Head Neck Surg. 2002 Oct;127(4):253-9. doi: 10.1067/mhn.2002.128071.
Our goals were to define the most sensitive techniques of acoustic neuroma diagnosis, to examine their relative costs, and to propose diagnostic modality selection given the rarity of acoustic neuroma incidence and given the other costs that society faces in more commonly encountered diseases.
We conducted a MEDLINE search of the English language from 1966 to 2001 using the following keywords: acoustic neuroma, acoustic tumor, vestibular schwannoma, diagnosis, cost effectiveness, MRI, auditory brainstem response, brainstem audiometric evoked response, incidence, and prevalence.
Although magnetic resonance imaging with gadolinium remains the most sensitive diagnostic modality in the discovery of acoustic neuromas, its cost may be prohibitive for some societies.
Which modality to use in acoustic neuroma diagnosis is just as much a philosophical and macroeconomic question as a technological one.
The cost of a timely diagnosis of acoustic neuromas must be weighed against using resources for other, more pressing, health concerns.
我们的目标是确定诊断听神经瘤最敏感的技术，研究其相对成本，并鉴于听神经瘤发病率较低以及社会在更常见疾病方面面临的其他成本，提出诊断方式的选择建议。
我们使用以下关键词对1966年至2001年的英文医学文献进行了MEDLINE检索：听神经瘤、听神经肿瘤、前庭神经鞘瘤、诊断、成本效益、磁共振成像、听觉脑干反应、脑干听觉诱发电位、发病率和患病率。
尽管钆增强磁共振成像仍是发现听神经瘤最敏感的诊断方式，但对某些社会而言，其成本可能过高。
在听神经瘤诊断中使用哪种方式，既是一个技术问题，也是一个哲学和宏观经济问题。
必须权衡及时诊断听神经瘤的成本与将资源用于其他更紧迫的健康问题。
