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Type: Journal article
Title: Addressing "waste" in diagnostic imaging: Some implications of comparative effectiveness research
Author: Elshaug, A.
Bessen, T.
Moss, J.
Hiller, J.
Citation: Journal of the American College of Radiology, 2010; 7(8):603-613
Publisher: Elsevier
Issue Date: 2010
ISSN: 1546-1440
Statement of
Adam G. Elshaug, Taryn Bessen, John R. Moss and Janet E. Hiller
Abstract: Comparative effectiveness research is intended to provide evidence to improve patient outcomes through the use of the most appropriate health technology affordable. The authors present 5 case studies, focusing on the use of plain radiography in common clinical scenarios, to illustrate the considerable scope for comparative effectiveness research within medical imaging and the different levels of evidence currently in existence to guide the improved use of medical imaging. These are blunt ankle injury, breast cancer follow-up, low back pain, routine daily chest x-rays in intensive care, and screening for breast cancer. Although there are established models for evaluating new technologies, especially pharmaceuticals, against the most commonly used current technology, the evaluation of technologies in current clinical practice is in an early phase of development. Because evaluation resources are limited, one major challenge is developing ways to identify established technologies for evaluation to refine the indications for their use. A set of criteria with which to identify established technologies that may not be delivering value for money is described, and their use is illustrated in relation to the 5 case studies. These criteria could be incorporated into literature search strategies, stakeholder consultations, and utilization scanning. Once identified, these technologies should be formally evaluated for their performance in improving patient health without restricting the availability of other effective interventions.
Keywords: Diagnostic imaging
comparative effectiveness research
cost effectiveness
evidence based medicine
Rights: Copyright © 2010 American College of Radiology American College of Radiology. Published by Elsevier Inc.
DOI: 10.1016/j.jacr.2010.03.010
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