Overuse of expensive neuroimaging for patients who present to emergency departments with dizziness could be spared by utilizing guideline concordant imaging when those same individuals are seen in outpatient settings. 

That’s according to new research published in JAMA Otolaryngol Head Neck Surgery that examined the prevalence and cost of neuroimaging for dizziness in multiple care settings. More than 800,000 Medicare claims involving dizziness as a symptom of concern were calculated to have cost more than $88 million in neuroimaging spending, according to the research. To reduce these costs, experts involved in the study suggested that appropriate triage and interventions must occur earlier in the patient care process to discourage discordant use of imaging studies. 

“Overuse of costly neuroimaging technology is associated with low-value care for the prevalent symptom of dizziness,” Meredith E. Adams, MD, of the Department of Otolaryngology–Head and Neck Surgery at the University of Minnesota, and co-authors explained. “Although quality improvement initiatives have focused on the overuse of computed tomography scans in emergency departments, most patients with dizziness present to outpatient clinics.” 

Researchers analyzed 805,454 commercial and Medicare Advantage claims on adults with a new diagnosis of dizziness that were submitted between Jan. 1, 2006, through Dec. 31, 2015. The types of imaging—CT, MRI, angiography, etc.—were compared to associated costs, settings and sociodemographic characteristics.