Evidence map›Paper›PMID 19413465›Full record

ArticleJournal of neurotrauma2009

The economic impact of S-100B as a pre-head CT screening test on emergency department management of adult patients with mild traumatic brain injury.

Shuolun Ruan, Katia Noyes, Jeffrey J Bazarian

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurotrauma, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 3 pooled it
3.7field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 53 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
  6. Article
  7. Review
  8. Article
  9. Observational
  10. Article
  11. Article
  12. Review
  13. Article
  14. Observational
  15. Article
  16. Article
  17. Article
  18. Observational
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Shuolun RuanDepartment of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA. shuolun.ruan@aya.yale.edu
Katia Noyes
Jeffrey J Bazarian
University of Rochester · US

Funding

UNIVERSITY OF ROCHESTER'S RESEARCH ASSOCIATE ORGANIZATIONUL1RR024160 · NCRR · UNIVERSITY OF ROCHESTER · PI PEARSON, THOMAS ARTHUR · 2006 to 2011
$38.7M
Detecting Axonal Damage After Mild Traumatic Brain InjuryR01HD051865 · NICHD · UNIVERSITY OF ROCHESTER · PI BAZARIAN, JEFFREY JOHN · 2007 to 2009
$1.6M
Economic and Policy Analyses in Geriatric DiseaseK01AG020980 · NIA · UNIVERSITY OF ROCHESTER · PI NOYES, EKATERINA I · 2002 to 2006
$543k
NCRR NIH HHS 1 UL1 RR024160-01NCRR NIH HHS UL1 RR024160NIA NIH HHS K01 AG20980NICHD NIH HHS 1R01HD051865
6 · The paper itself

Abstract

Recent research suggests that serum S-100B may serve as a good pre-head computed tomography (CT) screening test because of its high sensitivity for abnormal head CT scans. The potential economic impact of using S-100B in the emergency department setting for management of adult patients with isolated mild traumatic brain injury (mTBI) has not been evaluated despite its clinical implementation in Europe. Using evidence from the literature, we constructed a decision tree to compare the average cost per patient of using S-100B as a pre-head CT screening test to the current practice of ordering CT scans based on patients' presenting symptoms without the aid of S-100B. When compared to scanning 45-77% of isolated mTBI patients based upon their presenting symptoms, using S-100B as a pre-head CT screen does not lower hospital costs ($281 versus $160), primarily due to its low specificity for abnormal head CT scans. Sensitivity analyses showed, however, that S-100B becomes cost-lowering when the proportion of mTBI patients being scanned exceeds 78%, or when final CT scan results require 96 min or more than the wait for blood test results. Generally speaking, if blood test results require less time than imaging, and if head CT scan rates for patients with isolated mTBI are relatively high, using S-100B will lower costs. Recommendations for using S-100B as a screening tool should account for setting-specific characteristics and their consequent economic impacts. Despite its high sensitivity and excellent negative predictive value, serum S-100B has low specificity and low positive predictive value, limiting its ability to reduce numbers of CT scans and hospital costs.

Indexed as

AdultAxonsBiomarkersBlood Chemical AnalysisBrainBrain InjuriesCost-Benefit AnalysisDecision TreesDiffuse Axonal InjuryEmergency Medical ServicesEmergency Service, HospitalFalse Negative ReactionsFemaleHospital CostsHumansMaleBiomarkersNerve Growth FactorsS100 Calcium Binding Protein beta SubunitS100 Proteins

Identifiers

PMID19413465
PMCPMC2822799
OpenAlexW2055774716

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.