RAPID METHOD FOR RIGOROUS ASSESSMENT OF RADIOLOGIC IMAGING TECHNOLOGIES

Rapid and rigorous technology evaluation is important for improving qu ality and cost in health care, particularly for swiftly changing, high ly 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 a n appropriate methodology. Its principal characteristics include study of outcomes, clinical relevance, multiinstitutional design, intensive communication, experienced data management and statistical centers, s ophisticated 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 11/4 years, the study achieved active participati on of treating physicians, which much enhanced the clinical relevance of the end points studied. The data supported extensive analyses, whic h included the effect of imaging on treatment plans, an important outc ome measure. The authors report the (limited) difficulties encountered and identify changes to ameliorate them. Thus revised, the methodolog y can serve as a model for future technology assessments.