Cervical Spine MRI in Trauma Patients with Normal CT Is Not Cost Effective

An analysis suggests that outcomes are worse and costs higher when MRI is performed.

A prior meta-analysis found that no important injuries were missed by cervical spine magnetic resonance imaging (MRI) in blunt trauma patients with altered mental status (NEJM JW Emerg Med Apr 2015 and Ann Intern Med 2015; 162:429). The same investigators now report the results of a cost-effectiveness analysis on this topic.

The analysis considered a hypothetical 40-year-old trauma patient with a normal cervical spine computed tomography (CT) scan and a Glasgow Coma Scale (GCS) score <13. Estimates of the likelihood and consequences of foreseeable outcomes were derived from the literature, and decision analytic techniques were used to calculate the costs and benefits of two follow-up strategies after normal CT findings: cervical spine MRI or…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Cervical Spine MRI in Trauma Patients with Normal CT Is Not Cost Effective

Topics

Reviewing Author