Comparison between radiography and magnetic resonance imaging for the detection of sacroiliitis in the initial diagnosis
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SCIENTIFIC ARTICLE
Comparison between radiography and magnetic resonance imaging for the detection of sacroiliitis in the initial diagnosis of axial spondyloarthritis: a cost-effectiveness study Natalia Gorelik 1 & Farah Tamizuddin 2 & Tatiane Cantarelli Rodrigues 3 & Luis Beltran 4 & Fardina Malik 5 & Soumya Reddy 5 & James Koo 6 & Naveen Subhas 7 & Soterios Gyftopoulos 8 Received: 16 November 2019 / Revised: 3 March 2020 / Accepted: 5 April 2020 # ISS 2020
Abstract Objective The purpose of our study was to determine the cost-effectiveness of radiography and MRI-based imaging strategies for the initial diagnosis of sacroiliitis in a hypothetical population with suspected axial spondyloarthritis. Materials and methods A decision analytic model from the health care system perspective for patients with inflammatory back pain suggestive of axial spondyloarthritis was used to evaluate the incremental cost-effectiveness of 3 imaging strategies for the sacroiliac joints over a 3-year horizon: radiography, MRI, and radiography followed by MRI. Comprehensive literature search and expert opinion provided input data on cost, probability, and utility estimates. The primary effectiveness outcome was qualityadjusted life-years (QALYs), with a willingness-to-pay threshold set to $100,000/QALY gained (2018 American dollars). Results Radiography was the least costly strategy ($46,220). Radiography followed by MRI was the most effective strategy over a 3-year course (2.64 QALYs). Radiography was the most cost-effective strategy. MRI-based and radiography followed by MRIbased strategies were not found to be cost-effective imaging options for this patient population. Radiography remained the most cost-effective strategy over all willingness-to-pay thresholds up to $100,000. Conclusion Radiography is the most cost-effective imaging strategy for the initial diagnosis of sacroiliitis in patients with inflammatory back pain suspicious for axial spondyloarthritis. Keywords Cost-effectiveness . Sacroiliitis . Axial spondyloarthritis . Radiography . Magnetic resonance imaging
This study was presented at the Annual Meeting of the Society of Skeletal Radiology in Scottsdale, AZ [1]. It was awarded an SSR Young Investigator Travel Award as well as a Best Paper Award (ESSR) by the Society of Skeletal Radiology. It was also presented at the European Society of Musculoskeletal Radiology 2019 Annual Meeting in Lisbon, Portugal. * Natalia Gorelik [email protected]
Soumya Reddy [email protected]
Farah Tamizuddin [email protected]
James Koo [email protected]
Tatiane Cantarelli Rodrigues [email protected]
Naveen Subhas [email protected]
Luis Beltran [email protected] Fardina Malik [email protected]
Soterios Gyftopoulos [email protected] Extended author information available on the last page of the article
Skeletal Radiol
Introduction
General model overview
Axial spondyloarthritis (axSpA) is a rheumatic disease of the axial skeleton which affects about 0.7% of the US
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