Clinical and financial audit of diagnostic protocols for lesions of the cerebellopontine angle.

摘要: OBJECTIVE--To assess the diagnostic efficiency and costs of protocols used for investigating patients with suspected lesions cerebellopontine angle. DESIGN--Prospective evaluation tests auditory brain stem responses acoustic reflex thresholds, electronystagmography, calorics. Positive test results were confirmed or refuted by high resolution computed tomography intravenous enhancement. SETTING--Single general otolaryngology clinic in a teaching hospital. PATIENTS--270 consecutive sensorineural hearing loss requiring investigation to exclude lesion MAIN OUTCOME MEASURES--Estimated various performance detecting tumours RESULTS--Protocols including thresholds as sifting before clinically acceptable presented considerable savings over use all (74,000 pounds 84,000 v 122,000 pounds). The electronystagmography calorics could not be justified on clinical financial grounds. CONCLUSIONS--Audiological followed constitute most cost effective protocol determining IMPLICATIONS--The effectiveness should evaluated throughout health service.