Decision analysis of auditory brainstem responses and rotational vestibular tests in acoustic tumor diagnosis

This study addresses the problem of the escalation of the costs of medical care which make diagnosis of acoustic tumor expensive. Specifically, we examined the hypothesis that a test protocol of the auditory brainstem response (ABR) in parallel with sinusoidal harmonic acceleration (SHA) is more cost-effective in identification of the risk of tumor than ABR alone. The subjects were 74 patients with acoustic tumors and 78 controls. ABR and SHA data from these subjects were submitted to decision analysis. ABR was more cost-effective than the protocol of ABR in parallel with SHA. Using these data, we outlined a "decision tree" for acoustic tumor diagnosis that fit the goals of high sensitivity when earlier probability of tumor was high, and high specificity when earlier probability of tumor was low.