Assessment of Diagnostic Technology in Health Care: Rationale, Methods, Problems, and DirectionsTechnology assessment can lead to the rapid application of essential diagnostic technologies and prevent the wide diffusion of marginally useful methods. In both of these ways, it can increase quality of care and decrease the cost of health care. This comprehensive monograph carefully explores methods of and barriers to diagnostic technology assessment and describes both the rationale and the guidelines for meaningful evaluation. While proposing a multi-institutional approach, it emphasizes some of the problems involved and defines a mechanism for improving the evaluation and use of medical technology and essential resources needed to enhance patient care. |
Contents
Introduction | 1 |
Rationale for Assessment of Diagnostic Technology | 8 |
A Probabilistic Approach | 23 |
Copyright | |
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abnormal Abrams American Medical Association Annals of Internal assessment of diagnostic Bayes bias centers Chapter clinical outcome clinician compared computed tomography cooperative coronary artery disease cost-effectiveness analysis costs decision detect diagnostic technology diagnostic tests effects efficacy electrocardiogram endpoint England Journal enrollment evaluation example exercise test expected-value decisionmaking false-negative false-positive rate follow-up gallium imaging gold-standard test Health Care Technology hospital ideal study imaging impact important index test institution interpretation investigators Journal of Medicine likelihood ratio magnetic resonance imaging McNeil measure Medical Technology Meinert ment methods monitoring multicenter number of patients participating percent physician posttest probability pretest probability probability of disease problems procedure protocol development pulmonary embolism Radiology randomized trial research assistant ROC curve sample sensitivity and specificity standard studies of diagnostic study design study population subgroups surgery technology assessment test performance therapeutic tion treatment threshold probability true-positive rate U.S. Congress U.S. Government Printing ultrasound