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Methodologic Considerations in Planning Clinical Trials of Cost-Effectiveness of Magnetic Resonance Imaging With a Commentary on Guyatt and Drummond

Published online by Cambridge University Press:  10 March 2009

Milton C. Weinstein
Affiliation:
Harvard School of Public Health

Extract

The purpose of this paper is to outline some of the key methodologic issues in designing clinical trials to assess the cost-effectiveness of clinical magnetic resonance imaging (MRI). Because the possible objectives of such trials are so diverse, and the appropriate methodologies correspondingly numerous, no attempt is made to identify a single objective or methodology as appropriate. Rather, this paper should be read as an “options paper,” in which alternative formulations of objectives, outcome measures, study design, and protocol instrumentation are reviewed, with critical discussion of their theoretical strengths and weaknesses, as well as their practical implementability.

Type
An International View of Magnetic Resonance—Imaging and Spectroscopy
Copyright
Copyright © Cambridge University Press 1985

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References

REFERENCES

1.Guyatt, G., and Drummond, M. Guidelines for the clinical and economic assessment of health technologies: The case of magnetic resonance. (This issue p. 551.)CrossRefGoogle Scholar
2.Weinstein, M. C. and Stason, W. B.Foundations of cost-effectiveness analysis for health and medical practices. New Eng J Med, 296: 716721, 1985.CrossRefGoogle Scholar
3.Office of Technology Assessment, U.S. Congress. The implications of cost-effectiveness analysis of medical technology. OTA-H-126. Washington, D.C.: GPO, 1980.Google Scholar
4.Warner, K. E. and Luce, B. R.Cost-benefit and cost-effectiveness analysis in health care: principles, practice, and potential. Ann Arbor: Health Administration Press, 1982.Google Scholar
5.Fineberg, H. V., Bauman, R., and Sosman, M.Computerized cranial tomography: Effect on diagnostic and therapeutic plans. JAMA 1977; 238: 224227.CrossRefGoogle ScholarPubMed
6.Wittenberg, J., Fineberg, H. V., Black, E. B., Kirkpatrick, R. H., Schaffer, D. L., Ikeda, M. K., and Ferrucci, J. T. Jr, Clinical efficacy of computed body tomography. Am J Roentgenol 1978; 131: 514.CrossRefGoogle ScholarPubMed
7.Doubilet, P., Weinstein, M. C., and McNeil, B. J.The decision concerning coronary angiography in patients with chest pain: A cost-effectiveness analysis. Med Decis Making, in press.Google Scholar
8.Hemenway, D., Sherman, H., Mudge, G. H. Jr et al. , Comparative costs vcrsus symptomatic and employment benefits of medical and surgical treatment of table angina pectoris. Med Care 1985; 23: 133141.Google Scholar
9.Hanley, J. A., and McNeil, B. J.The meaning and use of the area under a ROC curve. Radiology 1982; 143: 2936.CrossRefGoogle Scholar
10.Hanley, J. A., and McNeil, B. J.A method of comparing the areas under ROC curves derived from the same cases. Radiology 1983; 148: 839843.CrossRefGoogle ScholarPubMed
11.Swets, J. A., Pickett, R. M., Whitehead, S. F. et al. Assessment of diagnostic technologies. Science 1979; 205: 753759.CrossRefGoogle ScholarPubMed
12.Greenes, R. H., Cain, K. C., and Begg, C. B.Patient-oriented performance measures of diagnostic tests: 1. Tools for prospective evaluation of test order decisions. Med Decis Making 1984; 4: 715.CrossRefGoogle ScholarPubMed