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Early MRI versus conventional management in the detection of occult scaphoid fractures: what does it really cost? A rural pilot study

Kelson, Tamika, Davidson, Robert and Baker, Tim 2016, Early MRI versus conventional management in the detection of occult scaphoid fractures: what does it really cost? A rural pilot study, Journal of medical radiation sciences, vol. 63, no. 1, pp. 9-16, doi: 10.1002/jmrs.153.

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Title Early MRI versus conventional management in the detection of occult scaphoid fractures: what does it really cost? A rural pilot study
Author(s) Kelson, Tamika
Davidson, Robert
Baker, TimORCID iD for Baker, Tim orcid.org/0000-0003-1893-5966
Journal name Journal of medical radiation sciences
Volume number 63
Issue number 1
Start page 9
End page 16
Total pages 8
Publisher Wiley-Blackwell
Place of publication Chichester, Eng.
Publication date 2016-03
ISSN 2051-3909
Keyword(s) Cost
MRI
fracture
management
scaphoid
Adolescent
Adult
Australia
Cost-Benefit Analysis
Female
Fractures, Closed
Humans
Magnetic Resonance Imaging
Male
Pilot Projects
Rural Population
Scaphoid Bone
Summary INTRODUCTION: To compare the cost-effectiveness and patient impact between acute magnetic resonance imaging (MRI) management and conventional management in the diagnosis of occult scaphoid fractures in a rural setting. METHODS: Consecutive patients presenting to a rural emergency department (ED) with a suspected scaphoid fracture were randomly assigned to either conventional management (6) or acute MRI management (10) (3 patients were excluded from the study analysis). All healthcare costs were compared between the two management groups and potential impacts on the patients' pain, mobility and lifestyle were also measured. RESULTS: There were no significant differences between the two groups at baseline. There was one (10%) scaphoid fracture in the MRI group and none in the conventional group (P = 0.42). A larger proportion of other fractures were diagnosed in the MRI group (20% (2) vs. 16.7% (1), P = 0.87), as well as less clinic attendances (1 (0-2.25) vs. 4 (2.25-5)) and diagnostic services (1 (1-1.25) vs. 2 (1-3)). Median management costs were $485.05 (AUD) (MRI) and $486.90 (AUD) (conventional). The MRI group had better pain and satisfaction scores as well as less time of immobilisation, treatment and time off work. CONCLUSION: MRI dramatically reduces the amount of unnecessary immobilisation, time of treatment and healthcare usage in a rural setting. The two protocols are suggested to be equivalent financially. When potential societal costs, the amount of unnecessary immobilisation, low prevalence of true fractures and patient satisfaction are considered, acute MRI should be the management technique of choice. Further studies are still required to assess the best method for managing bone bruise within the scaphoid.
Language eng
DOI 10.1002/jmrs.153
Field of Research 110320 Radiology and Organ Imaging
Socio Economic Objective 920199 Clinical Health (Organs
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution Non-Commercial No-Derivatives licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30091770

Document type: Journal Article
Collections: School of Medicine
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.