ECONOMIC-ANALYSES OF RADIOLOGICAL PROCEDURES - A METHODOLOGICAL EVALUATION OF THE MEDICAL LITERATURE

Objective: Increasing pressure to curb health care costs has led to co nsiderable interest in economic analyses, including both cost-effectiv eness and cost-benefit analyses. Numerous economic analyses of radiolo gical procedures have appeared in both the radiology and non-radiology literature. The objective of this study was to evaluate the methodolo gical quality of economic analyses of radiological procedures publishe d in the non-radiology medical literature during the years 1990-1995. Methods: Original investigations from the medical (non-radiological) l iterature that include economic analyses of radiological interventions were identified from a computerized literature search. Each economic analysis article was evaluated by two independent reviewers for adhere nce to ten methodological criteria. The criteria were derived from rev iew of the medical and radiological economic analysis methodology lite rature and consisted of the following: (1) Comparative options stated; (2) perspective of analysis defined; (3) outcome measure identified; (4) cost data included; (5) source of cost data stated; (6) long term costs included; (7) discounting employed; (8) summary measure provided ; (9) incremental computation method used; and (10) sensitivity analys is performed. The results were compared to a previous study that evalu ated the radiological literature. Results: Of the 56 articles in the m edical literature that included economic analyses of radiological proc edures, only eight (14%) conformed to all ten methodological criteria. The cost data (98%) and comparative options (89%) criteria exhibited high compliance, while the perspective of analysis (25%) and discounti ng (32%) criteria had relatively low compliance. Agreement between the reviewers was excellent (kappa=0.88). Conclusions: Published economic analyses of radiology procedures usually do not meet accepted methodo logical standards. (C) 1998 Elsevier Science Ireland Ltd. All rights r eserved.