Medical Student Vanderbilt University School of Medicine Nashville, Tennessee, United States
Introduction: Previous literature has noted only limited associations between vestibular schwannoma (VS) tumor size and symptom severity at diagnosis, as well as symptom progression and tumor growth, suggesting the necessity of a “wait-and-scan” strategy. Our aim is to conduct a meta-analysis of the published literature on costs associated with preoperative vestibular schwannoma screening.
Methods: A systematic review of the literature for cost of vestibular schwannoma treatment was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies from all countries were considered, and Pubmed and Embase databases were queried. Historical currency exchange rates provided by OANDA were used to convert to a common denominational currency for this study, dollars. Cost was corrected for inflation to April 2022.
Results: Of 407 articles, 12 were included in the final analysis. The included articles spanned years 1990 to 2020, and the data most commonly came from the United States (N=5) and the United Kingdom (N=3). 11 (91.7%) of the studies were single-center studies and 1 (8.3%) was a multi-center study, with patient numbers ranging from 72 to 1,249. The currency-corrected and inflation corrected mean cost was $395.42 (range, $21.81 to $654.14) (N=5) for auditory brainstem response, $1,492.53 ($511.64 to $1,433.87) (N=3) for CT scan, $2,503.75 ($317.14 to $13,889.14) (N=8) for spin MRI sequence, and $4,544.97 ($327.30 to $14,066.22) (N=6) for enhanced MRI screen. In terms of cost reporting, of the 12 articles, 1 (8.3%) of them separated out the cost elements and 10 (83%) of them used local prices, 1 (8.3%) used Medicare charges, and 1 (8.3%) used an online estimation.
Conclusion : Our findings describe the limited data on published costs for screening of VS. The paucity of data and significant variability of costs between studies indicates that this endpoint is relatively unexplored, and the cost of screening is poorly understood.
