Value of Routine CT Scans in Follow-Up of Hodgkin's Disease
Author Information
Author(s): Dryver E T, Jernström H, Tompkins K, Buckstein R, Imrie K R
Primary Institution: Toronto Sunnybrook Regional Cancer Centre
Hypothesis
The study aims to evaluate the effectiveness of routine CT scans in detecting relapses in patients with Hodgkin's disease after curative treatment.
Conclusion
Routine CT scans are costly and provide little value in identifying relapses in Hodgkin's disease follow-up.
Supporting Evidence
- Two-thirds of relapses were identified clinically.
- Routine radiological tests identified a quarter of all relapses.
- 211 routine CT scans were performed which detected only two of 22 relapses.
- Cost per identification of a true relapse was approximately US $6000.
- 84% of the costs of follow-up were incurred by routine tests.
Takeaway
Doctors checked patients for signs of Hodgkin's disease coming back, but using CT scans didn't help much and cost a lot of money.
Methodology
A retrospective review of adult patients with classical Hodgkin's disease followed at the Toronto Sunnybrook Regional Cancer Centre from 1990 to 1999.
Potential Biases
The hierarchical grading system used to attribute suspected relapses may have biased against radiological investigations.
Limitations
The study may not be generalizable to patients with high-risk disease due to the low percentage of patients with advanced stages.
Participant Demographics
Median age was 33 years (range 17–82), with 57% male and 43% female.
Statistical Information
P-Value
0.013
Confidence Interval
95% CI 1.57–45.4
Statistical Significance
p=0.013
Digital Object Identifier (DOI)
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