TY - JOUR
T1 - Evaluation of diagnostic procedures. A review of the issues
AU - Thompson, Mark S.
AU - Cohen, Alan B.
AU - Fortess, Eric E.
N1 - Funding Information:
This work was supported by grants from the Robert Wood Johnson Foundation and the Commonwealth Fund to the Center for the Analysis of Health Practices at the Harvard School of Public Health. Requests for reprints should be sent to Mark Thompson, School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115. The authors thank Jeb Brooks and a referee for their helpful comments.
PY - 1981
Y1 - 1981
N2 - The expensive proliferation of new diagnostic medical technologies necessitates their rigorous evaluation. Diagnosis seeks to improve health outcomes by providing better information to guide treatment decisions. Evaluation may focus on various links in the management of patients by investigating (1) how diagnostic technologies affect the the information available to the physician, (2) how improved Information affects treatment decisions, and (3) how altered treatment decision affect health outcomes. For diagnostic procedures that do improve health outcomes, the gain in health status should be weighed against potential cost increases. This comparison may be made using risk-benefit and cost-effectiveness analyses. Experience in evaluating diagnostic technologies has shown the importance of (1) estimating effect size, (2) randomizing, (3) blinding, (4) enhancing external validity, (5) accounting for patient characteristics, and (6) reflecting patient values. Errors in adopting new diagnostic procedures may be reduced through better coordination of development, evaluation, and dissemination. This requires (1) improved evaluative decision making, (2) restraint among potential users, and (3) accelerated evaluation.
AB - The expensive proliferation of new diagnostic medical technologies necessitates their rigorous evaluation. Diagnosis seeks to improve health outcomes by providing better information to guide treatment decisions. Evaluation may focus on various links in the management of patients by investigating (1) how diagnostic technologies affect the the information available to the physician, (2) how improved Information affects treatment decisions, and (3) how altered treatment decision affect health outcomes. For diagnostic procedures that do improve health outcomes, the gain in health status should be weighed against potential cost increases. This comparison may be made using risk-benefit and cost-effectiveness analyses. Experience in evaluating diagnostic technologies has shown the importance of (1) estimating effect size, (2) randomizing, (3) blinding, (4) enhancing external validity, (5) accounting for patient characteristics, and (6) reflecting patient values. Errors in adopting new diagnostic procedures may be reduced through better coordination of development, evaluation, and dissemination. This requires (1) improved evaluative decision making, (2) restraint among potential users, and (3) accelerated evaluation.
UR - http://www.scopus.com/inward/record.url?scp=0019744447&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0019744447&partnerID=8YFLogxK
U2 - 10.1016/0149-7189(81)90037-9
DO - 10.1016/0149-7189(81)90037-9
M3 - Article
C2 - 10309634
AN - SCOPUS:0019744447
SN - 0149-7189
VL - 4
SP - 385
EP - 396
JO - Evaluation and Program Planning
JF - Evaluation and Program Planning
IS - 3-4
ER -