Lisette van Dam

Cost-effectiveness of MRI for diagnosing recurrent ipsilateral DVT 3 51 MRDTI but had comparable or higher diagnostic certainty. Importantly, due to uncertainty of the risk for recurrent VTE, bleeding and mortality at long-term, we did not calculate the total health care costs > 1 year. Even so, the results would then be even more favorable for strategies including MRDTI, with a lower false- positive rate, since patients diagnosed with recurrent DVT are often treated with lifelong anticoagulants with subsequent risk for bleeding. This result, in the view of this detailed cost-effectiveness analysis, is an argument to incorporate the MRDTI scan in local protocols and international guidelines for the diagnostic work- up of suspected recurrent ipsilateral DVT in daily clinical practice. Since we did not directly compare the different strategies prospectively and had to base the model on several assumptions, we cannot determine which one would be the best strategy. Our analysis does however suggest to omit costs as a reason to dismiss the use of MRDTI in the diagnostic management of suspected recurrent ipsilateral DVT. In conclusion, our analysis shows that the diagnostic strategies involving MRDTI for suspected recurrent ipsilateral DVT have comparable or lower total 1-year health care costs, compared to strategies without MRDTI. Therefore, compared to CUS alone, applying MRDTI in clinical practice will not increase health care costs.