Neurodiagnostic tests in children with brain tumors: changing patterns of use and impact on cost.

The utilization of neurodiagnostic tests in the initial work-up in children with brain tumors was relatively stable during the three years before computed tomography (CT) became available. After this test became available there was a significant (P less than .05) reduction in the utilization of cerebral angiography, echoencephalography, electroencephalography, and ventriculography in children with tumors below the tentorium. In children with tumors above the tentorium, only a reduction in the use of cerebral angiography and radioisotopic scanning was demonstrated. These changes have resulted in a significant (P less than .05) reduction in cost to the patient (or third party) for the initial neurodiagnostic work-up. Since CT became available, children with brain tumors undergo fewer tests, and the greatest reduction has been in tests that have the greatest cost.