Citation

Su YS, Schuster JM, Smith DH, Stein SC. J. Neurotrauma 2019; 36(13): 2083-2091.

Affiliation

UPenn, Neurosurgery , 310 Spruce St , Philadelphia, Pennsylvania, United States , 19106 ; sherman.stein@uphs.upenn.edu.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2018.6020

PMID

30547708

Abstract

Intracranial hemorrhage after traumatic brain injury (TBI) can be life threatening and requires prompt diagnosis. CT scans are a rapid and accurate way to evaluate for hemorrhage. However, in patients with mild and moderate TBI, in whom the incidence of intracranial pathology is low, scanning every patient with CT can be costly. The FDA recently approved of a novel biomarker screen, the Banyan Trauma Indicator (BTI), to help streamline the decision for CT scanning in mild to moderate TBI. The BTI screen diagnoses intracranial lesions with a sensitivity and specificity of 97.5% and 99.6%, respectively. We performed cost analyses of the BTI screen to determine the threshold of cost-effectiveness, compared to application of clinical decision rules or routine CT scans, for cases of mild or moderate TBI. With a 0.104 probability of an intracranial lesion in mild TBI, the biomarker screen is cost effective if the cost is $308.96 or below per test. In moderate TBI, because of the greater prevalence of intracranial lesions at 0.663, there is a lower need for screening and BTI becomes cost-effective up to $73.41 per test.

Language: en

Keywords

BIOMARKERS; CT SCANNING; TRAUMATIC BRAIN INJURY