Substantial cost savings of ultrasound-based management over magnetic resonance imaging-based management in an inflammatory bowel disease service

Radford, Shellie J.; Abdul-Aema, Buraq; Tench, Chris; Leighton, Paul; Coad, Jane; Moran, Gordon W.

Abstract

Background: Imaging is used to monitor disease activity in small bowel Crohn’s disease (CD). Magnetic Resonance Enterography is often employed as a first modality in the United Kingdom for assessment and monitoring; however, waiting times, cost, patient burden and limited access are significant. It is as yet uncertain if small bowel intestinal ultrasound (IUS) may be a quicker, more acceptable, and cheaper alternative for monitoring patients with CD. Methods: A clinical service evaluation of imaging pathways was undertaken at a single NHS site in England, United Kingdom. Data were collected about patients who were referred and underwent an imaging analysis for their IBD. Only patients who underwent a therapy change were included in the analysis. Data were collected from care episodes between 01 January 2021–30 March 2022. Results: A combined total of 193 patient care episodes were reviewed, 107 from the IUS pathway and 86 from the MRE pathway. Estimated costs per patient in the IUS pathway was £78.86, and £375.35 per patient in the MRE pathway. The MRE pathway had an average time from referral to treatment initiation of 91 days (SD= ±61) with patients in the IUS pathway waiting an average of 46 days (SD= ±17). Conclusions: Findings from this work indicate that IUS is a potential cost-saving option when compared to MRE when used in the management of CD. This is in addition to the cost difference of the radiological modalities. A large, multicentre, prospective study is needed to validate these initial findings.

Citation

Radford, S. J., Abdul-Aema, B., Tench, C., Leighton, P., Coad, J., & Moran, G. W. (2024). Substantial cost savings of ultrasound-based management over magnetic resonance imaging-based management in an inflammatory bowel disease service. Scandinavian Journal of Gastroenterology, https://doi.org/10.1080/00365521.2024.2330588

• Journal Article Type: Article
• Acceptance Date: Mar 8, 2024
• Online Publication Date: Mar 19, 2024
• Publication Date: Mar 19, 2024
• Deposit Date: Mar 8, 2024
• Publicly Available Date: Mar 20, 2025
• Journal: Scandinavian Journal of Gastroenterology
• Print ISSN: 0036-5521
• Electronic ISSN: 1502-7708
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1080/00365521.2024.2330588
• Keywords: Crohn’s disease; IBD; ultrasound; cost implications
• Public URL: https://nottingham-repository.worktribe.com/output/32176919
• Publisher URL: https://www.tandfonline.com/doi/full/10.1080/00365521.2024.2330588
• Additional Information: Peer Review Statement: The publishing and review policy for this title is described in its Aims & Scope.; Aim & Scope: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=igas20; Received: 2023-12-19; Accepted: 2024-03-08; Published: 2024-03-19