{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:43:09Z","timestamp":1789785789445,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the cost\u2010effectiveness of auditory brainstem response prior to MRI (ABR\u2010MRI) compared to standalone MRI to diagnose vestibular schwannoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A state transition model was developed to simulate costs and effects (quality\u2010adjusted life years [QALY]) for both diagnostic strategies for patients suspected of a vestibular schwannoma. Model input was derived from literature, hospital databases and expert opinions. Scenario and sensitivity analyses addressed model uncertainty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over a lifetime horizon, ABR\u2010MRI resulted in a limited cost\u2010saving of \u20ac68 or \u20ac98 per patient (dependent on MRI sequence) and a health loss of 0.005 QALYs over standalone MRI. ABR\u2010MRI, however, did miss patients with other important pathology (2% of the population) that would have been detected when using standalone MRI. In total, \u20ac14\u00a0203 or \u20ac19\u00a0550 could be saved per lost QALY if ABR\u2010MRI was used instead of standalone MRI. The results were sensitive to the detection rate of vestibular schwannoma and health\u2010related quality of life of missed patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The cost\u2010saving with ABR\u2010MRI does not seem to outweigh the number of missed patients with VS and other important pathologies that would have been detected when using standalone MRI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13894","type":"journal-article","created":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T14:52:31Z","timestamp":1637074351000},"page":"295-303","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Auditory brainstem response prior to MRI compared to standalone MRI in the detection of vestibular schwannoma: A\u00a0modelling study"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3782-6677","authenticated-orcid":false,"given":"Stan R. W.","family":"Wijn","sequence":"first","affiliation":[{"name":"Department of Operating Rooms Radboud Institute of Health Sciences, Radboud University Medical Centre  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6106-089X","authenticated-orcid":false,"given":"Mayke A.","family":"Hentschel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Radboud Institute of Health Sciences, Radboud University Medical Centre  Nijmegen The Netherlands"},{"name":"Academic Alliance Skull Base Pathology, Radboud University Medical Centre &amp; Maastricht University Medical Centre  Nijmegen &amp; Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3191-6113","authenticated-orcid":false,"given":"Andy J.","family":"Beynon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Radboud Institute of Health Sciences, Radboud University Medical Centre  Nijmegen The Netherlands"},{"name":"Academic Alliance Skull Base Pathology, Radboud University Medical Centre &amp; Maastricht University Medical Centre  Nijmegen &amp; Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1162-6394","authenticated-orcid":false,"given":"Henricus P. 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