Boden S D, Labropoulos P A, Vailas J C
Department of Orthopedic Surgery, George Washington University Medical Center, Washington, DC 20037.
Arthroscopy. 1990;6(4):306-10. doi: 10.1016/0749-8063(90)90061-h.
Although magnetic resonance (MR) imaging has been established as an accurate diagnostic modality for knee pathology, the cost-effectiveness of this test is not known. In this investigation, we formulated a mathematical equation to assess cost-effectiveness and then used this formula to evaluate the use of knee MR as a diagnostic modality in acute knee injuries. We analyzed 105 consecutive MR scans performed at an imaging center with a diverse referral base, and identified 63 patients who had had symptoms for less than 6 months. Based on average regional medical costs, we calculated that diagnostic arthroscopy is more cost-effective than MR if 78% of the scanned patients eventually undergo arthroscopy. In our study population, 87% had arthroscopy after the MR scan. Therefore, in this patient cohort representing a diverse orthopedic community, arthroscopy alone would have been more cost-effective. Careful analysis in this type of cost-benefit framework would be beneficial and may lead to the establishment of objective criteria by which MR can be used in the most cost-effective manner.
尽管磁共振（MR）成像已成为诊断膝关节病变的一种准确方法，但该检查的成本效益尚不清楚。在本研究中，我们制定了一个数学方程式来评估成本效益，然后用这个公式来评估膝关节MR作为急性膝关节损伤诊断方法的使用情况。我们分析了在一个拥有多样化转诊来源的影像中心连续进行的105例MR扫描，并确定了63例症状持续时间少于6个月的患者。根据地区平均医疗费用，我们计算出，如果78%的扫描患者最终接受关节镜检查，那么诊断性关节镜检查比MR更具成本效益。在我们的研究人群中，87%的患者在MR扫描后接受了关节镜检查。因此，在这个代表不同骨科群体的患者队列中，仅进行关节镜检查可能更具成本效益。在这种成本效益框架下进行仔细分析将是有益的，并且可能会导致建立客观标准，从而以最具成本效益的方式使用MR。
