Economic evaluation studies in nuclear medicine: a methodological review of the literature

Background. The growing need for evaluation of the utility of new nuclear m edicine technologies has spawned a few economic studies ranging from prelim inary indications of cost savings to complete decision analysis models inco rporating costs and quality of life. The objective of the current study was to evaluate the methodological quality of economic analyses of nuclear med icine procedures which targeted cost-effectiveness or cost-utility issues p ublished in the medical Literature during the years 1985-1999. Methods. A computerized literature search was used to identify original inv estigations from the medical literature which included an economic analysis of a nuclear medicine procedure. Each economic analysis article was evalua ted by two independent reviewers for adherence to ten accepted methodologic al criteria. Results. Of the 29 articles meeting the search criteria, only six (21%) con formed to all ten methodological criteria. Conclusions. Published economic analyses of nuclear medicine procedures usu ally do not meet accepted methodological standards and could be significant ly improved to achieve overall better quality relative to similar analyses in the Literature from other medical fields. Continued improvement in the n umber and quality of economic studies is critically needed for the future c ompetitiveness of nuclear medicine studies.