| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Health Policy and Practice |
1 From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.J.O., F.J.R.); Department of Health Systems Management, Guilford Glazer School of Business and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel (D.G.); and Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts University School of Medicine, Boston, Mass (P.J.N.). Received February 4, 2008; revision requested April 3; revision received April 30; accepted June 4; final version accepted June 25. Supported in part by the Agency for Healthcare Research and Quality grant ROI HSI0919 for 2001–2004 and the National Library of Medicine grant 1 G08 LM008413 for 2004–2007. Address correspondence to H.J.O. (e-mail: hotero{at}partners.org).
Purpose: To determine the growth rate, methodologic clarity, and quality changes in cost-effectiveness analyses (CEAs) and to assess whether the U.S. Panel on Cost-effectiveness in Health and Medicine recommendations affected CEA studies in which imaging technologies were evaluated.
Materials and Methods: Six databases were systematically searched for CEA reports published between 1985 and 2005. All imaging-related studies were selected and grouped according to year, country, and journal of publication, as well as imaging modality and disease being studied. Two readers with formal training in decision analysis and CEA used a seven-point (1, low; 7, high) Likert scale based on reasonableness of assumptions, quality of presentation, and adherence to guidelines to independently evaluate study quality. Quality scores according to year, country, and journal of publication were compared with the unpaired Student t test.
Results: The first radiology-related CEA was published in 1985; 111 radiology-related CEAs were published between 1985 and 2005. The average number of studies increased from 1.6 per year between 1985 and 1995 to 9.4 per year between 1996 and 2005. Eighty-six studies were performed to evaluate diagnostic imaging technologies, and 25 were performed to evaluate interventional imaging technologies. Ultrasonography (35.0%), angiography (31.5%), magnetic resonance imaging (22.5%), and computed tomography (19.8%) were evaluated most frequently. Forty-nine studies received government funds; 42 did not disclose the source of funding. The mean quality score was 4.23 ± 1.12 (standard deviation), without significant improvement over time. Scores in studies performed in the United States were significantly higher than scores in studies that were not performed in the United States (4.45 ± 1.02 vs 3.61 ± 1.17, respectively; P < .01). Scores were also higher in journals with three or more CEA articles published during the study period than in journals with two or fewer CEA articles published during this period (4.54 ± 1.09 vs 3.91 ± 1.06, respectively; P < .01).
Conclusion: CEAs are an important tool with which to analyze the value of diagnostic imaging. However, improvement in the quality of analyses is needed.
Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/249/3/917/DC1
© RSNA, 2008
Related Article
Radiology 2008 249: 753-755.
