Rapid method for rigorous assessment of radiologic imaging technologies.

Abstract

Rapid and rigorous technology evaluation is important for improving quality and cost in health care, particularly for swiftly changing, highly technologic fields like radiology. Currently, however, evaluations are generally seriously deficient in quality, and rigorous evaluations typically require 4 years or more. Therefore, the authors developed an appropriate methodology. Its principal characteristics include study of outcomes, clinical relevance, multi-institutional design, intensive communication, experienced data management and statistical centers, sophisticated analysis, careful attention to the protocol and reference standard, on-site managers, and extensive pretesting and refinement. The authors successfully tested the methodology in a seven-institution study. Completed in 1 1/4 years, the study achieved active participation of treating physicians, which much enhanced the clinical relevance of the end points studied. The data supported extensive analyses, which included the effect of imaging on treatment plans, an important outcome measure. The authors report the (limited) difficulties encountered and identify changes to ameliorate them. Thus revised, the methodology can serve as a model for future technology assessments.