CLINICAL EFFICACY OF DIAGNOSTIC-IMAGING - LOVE IT OR LEAVE IT

The traditional goal of radiology has been to provide images of the hi ghest technical quality that permit the most accurate diagnoses possib le. From a more global perspective, diagnostic radiology is part of a larger system that has as its goal effective and efficient treatment o f patients. A six-tiered hierarchical model of efficacy that includes this more global view is presented. This model is intended to improve understanding of the continuum that efficacy is and to conceptually re late efficacy to technology assessment and outcome research. Better un derstanding of efficacy/technology assessment and outcome research fos tered by the model should encourage radiologists to participate active ly in federally supported research in these areas. Those radiologists who do so will come to understand better how radiology can help patien ts and society as a whole. Use of the model's concepts should also aid radiologists in becoming more effective consultants to their clinical colleagues about optimal use of high-technology imaging from the pers pectives of clinical efficacy, patient outcome, and societal efficacy.