Equivalence versus pragmatic trials for the economic evaluation of information and communication technologies; the case of polysomnography under telesurveillance in the diagnosis of sleep apnea syndrome

This article deals with the choice of the appropriate protocols for the ear ly economic evaluation of information and communication technologies, equiv alence trial versus pragmatic trial. The reasoning put forward here is base d on a concrete interrogation relative to polysomnograhy (PSG), a key diagn ostic test for sleep apnoea syndrome (SAS). Is PSG under tele-surveillance more efficient than ambulatory PSG to diagnose SAS? After analyzing and dis cussing both advantages and limits of these two kinds of trial, we showed t hat one or the other can be used to obtain appropriate results. But in this particular example, we concluded that a pragmatic trial should be preferre d, knowing that it requires a smaller sample of patients along with a narro wer range of uncertainty concerning the evaluation of costs. (C) 2001 Elsev ier Science Ireland Ltd. All rights reserved.