Key result
Selective use of a short MRI examination in patients with acute knee injury without a fracture on radiography reduced mean total costs to 1,973 euros compared to 2,593 euros with radiography alone, while improving quality of life.
Why the study?
Does selective short MRI examination reduce costs and improve quality of life in patients with acute knee injury without fracture on radiography?
RCT (n=208)
Open-label
Block randomization
No
Does selective short MRI examination reduce costs and improve quality of life in patients with acute knee injury without fracture on radiography?
Absolute Event Rate: 1973% vs 2593%
Selective use of a short MRI examination in patients with acute knee injury without a fracture on radiography reduces societal costs and improves early quality of life compared to radiography alone.
Supports selective short MRI in acute knee injury without fracture; confirms RCT-level cost and QoL benefits versus radiography alone.
The aim of this study was to assess the costs and effectiveness of selective short magnetic resonance imaging (MRI) in patients with acute knee injury. A model was developed to evaluate the selective use of MRI in patients with acute knee injury and no fracture on radiography based on the results of a trial in which 208 patients were randomized between radiography only and radiography plus MRI. We analyzed medical (diagnostic and therapeutic) costs, quality of life, duration of diagnostic workup, number of additional diagnostic examinations, time absent from work, and time to convalescence during a 6-month follow-up period. Quality of life was lowest (EuroQol at 6 weeks 0.61 (95% CI 0.54-0.67)); duration of diagnostic workup, absence from work, and time to convalescence were longest; and the number of diagnostic examinations was largest with radiography only. These outcomes were more favorable for both MRI strategies (EuroQol at 6 weeks 0.72 (95% CI 0.67-0.77) for both). Mean total costs were 2,593 euros (95% CI 1,815-3,372) with radiography only, 2,116 euros (95% CI 1,488-2,743) with radiography plus MRI, and 1,973 euros (95% CI 1,401-2,543) with selective MRI. The results suggest that selective use of a short MRI examination saves costs and potentially increases effectiveness in patients with acute knee injury without a fracture on radiography.
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Oei et al. (2008) conducted an RCT in Acute knee injury (n=208). Selective short MRI examination (if no fracture on radiography) vs. Radiography only was evaluated on Mean total costs. Selective use of a short MRI examination in patients with acute knee injury without a fracture on radiography reduced mean total costs to 1,973 euros compared to 2,593 euros with radiography alone, while improving quality of life.
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