+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Cost effectiveness of magnetic resonance imaging in the workup of the dysosmia patient



Cost effectiveness of magnetic resonance imaging in the workup of the dysosmia patient



International Forum of Allergy and Rhinology 3(1): 56-61



Intracranial causes of dysosmia are uncommon. Nonetheless, a missed intracranial disorder or neoplasm is worrisome. Magnetic resonance imaging (MRI) may be used in diagnosis; however, the cost effectiveness of this practice is unclear. We hypothesize that MRI scans for idiopathic dysosmia will demonstrate sufficient significant findings to be a cost-effective screening tool. Tertiary-care otolaryngology clinic records were queried for smell and taste disturbance. The patients underwent anosmia-protocol MRI of the brain for idiopathic dysosmia in 122 cases. Each MRI report was reviewed for dysosmia findings, intracranial neoplasms, and incidental findings. MRI was normal in 44.3%, there were dysosmia-related findings in 25.4%, and incidental findings in 40.2%. The most common related diagnosis was occult frontoethmoid sinusitis (18.8%). The most common incidental diagnosis was small vessel disease (21.1%). Intracranial neoplasms were observed in 6 patients (4.9%). Nine patients had intracranial causes of dysosmia including olfactory meningiomas, infarct, trauma, and atrophy. MRI cost per dysosmia etiology diagnosis was $9445. Costs increased to $32,355 and $48,880 per intracranial cause or neoplasm, respectively. Cost to diagnose 1 causal intracranial neoplasm was $146,400. From 1997 to 2003, median medical malpractice settlements ranged from $625,616 for misdiagnosis to $682,500 for delay in treatment to $1,750,000 for brain injury. The median jury award was $975,000 for misdiagnosis, $1,550,000 for delayed treatment, and $6,000,000 for brain injury. MRI in idiopathic dysosmia yielded information regarding the diagnosis in one-quarter of cases. The implications of missing an intracranial neoplasm alone justify the cost of screening MRI for idiopathic dysosmia.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 036492699

Download citation: RISBibTeXText

PMID: 22786891

DOI: 10.1002/alr.21066


Related references

The diagnostic accuracy and cost-effectiveness of magnetic resonance spectroscopy and enhanced magnetic resonance imaging techniques in aiding the localisation of prostate abnormalities for biopsy: a systematic review and economic evaluation. Health Technology Assessment 17(20): Vii-Xix, 1-281, 2014

Cost-benefit and cost-effectiveness analyses of magnetic resonance imaging. International Journal of Technology Assessment in Health Care 1(3): 537-550, 1984

Cost-effectiveness of magnetic resonance imaging and enteroclysis in the diagnostic imaging of Crohn's disease. International Journal of Technology Assessment in Health Care 18(3): 711-717, 2002

Cost effectiveness of magnetic resonance imaging. Bmj 304(6820): 183, 1992

Cost effectiveness of magnetic resonance imaging. Bmj 304(6825): 508, 1992

Cost effectiveness of magnetic resonance imaging. Bmj 304(6820): 183-184, 1992

Cost effectiveness of magnetic resonance imaging of the knee. Magnetic Resonance Imaging Clinics of North America 2(3): 475-479, 1994

Cost effectiveness of magnetic resonance imaging in the neurosciences. Bmj 303(6815): 1435-1439, 1991

Cost-effectiveness of magnetic resonance imaging in internal derangement of the knee. Arthritis & Rheumatism 40(9 SUPPL ): S170, Sept, 1997

Cost-effectiveness of computerized tomography and magnetic resonance imaging in dementia. Medical Decision Making 5(3): 335-354, 1985

The cost-effectiveness of magnetic resonance imaging for investigation of the knee joint. Health Technology Assessment 5(27): 1-95, 2001

Cost-effectiveness of magnetic resonance imaging in specific situations in India. Academic Radiology 3 Suppl 1: S113-S115, 1996

The "PROMIS" of Magnetic Resonance Imaging Cost Effectiveness in Prostate Cancer Diagnosis?. European Urology 73(1): 31-32, 2017

Cost-effectiveness of adding magnetic resonance imaging to rheumatoid arthritis management. Archives of Internal Medicine 171(7): 657-667, 2011

Cost-effectiveness of computed tomography scanning and magnetic resonance imaging in China. Academic Radiology 3 Suppl 1: S116-S117, 1996