Assessing the Value of a Diagnostic Test

Heidenreich, Paul A.

doi:10.1001/archinternmed.2009.208

Cited by 5 publications

(8 citation statements)

References 7 publications

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“…Among the value-added contributions of an imaging examination toward patient care, those that influence diagnostic thinking and provide information that can guide treatment recommendations are very important [12,15,16]. In this study, we showed MRN has an ability to significantly affect the diagnostic workup and therapeutic recommendations in patients presenting with suspected peripheral neuropathy for surgical evaluation.…”

Section: Discussionmentioning

confidence: 76%

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

et al. 2015

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Section: Discussionmentioning

confidence: 76%

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

et al. 2015

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Section: Introductionmentioning

confidence: 99%

“…Advanced imaging technologies, such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), have led to major enhancements (ie, speed, precision, and accuracy) in a physician's ability to better diagnose and treat a variety of diseases, to rule out medical conditions, and to prevent painful and expensive treatments . Not surprisingly, the use of these technologies, and thus all related costs, have increased more rapidly than other physician‐ordered services (eg, plain X‐rays) across virtually all clinical specialties . Increasingly, concern has been raised about the value—in terms of improving health outcomes or reducing the use of other more expensive or invasive diagnostic tests—health care purchasers and beneficiaries are gaining from the greater use of advanced, high‐cost imaging technologies .…”

Section: Introductionmentioning

confidence: 99%

“…Not surprisingly, the use of these technologies, and thus all related costs, have increased more rapidly than other physician‐ordered services (eg, plain X‐rays) across virtually all clinical specialties . Increasingly, concern has been raised about the value—in terms of improving health outcomes or reducing the use of other more expensive or invasive diagnostic tests—health care purchasers and beneficiaries are gaining from the greater use of advanced, high‐cost imaging technologies . The negative implications for health care quality and costs, including unnecessary exposure to radiation, false‐positive and false‐negative results, delays in diagnosis, ineffective allocation of resources, and growth in health care costs resulting from the overuse of some medical imaging are increasingly being recognized in the scholarly and policy literature …”

Section: Introductionmentioning

confidence: 99%

“…Conventional accuracy measures of sensitivity (detecting disease if present) and specificity (excluding disease if absent) are typically used in imaging development; however, they do not provide enough information to decide whether a new diagnostic strategy will improve outcomes (effectiveness) or efficiency . A number of authors have emphasized the importance of measuring the value (through improved outcomes and efficiency) attributable to high technology medical imaging …”

Section: Introductionmentioning

confidence: 99%

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Adoption of high technology medical imaging and hospital quality and efficiency: Towards a conceptual framework

Sandoval

Brown

Wodchis

et al. 2018

Health Planning & Management

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Measuring the value of medical imaging is challenging, in part, due to the lack of conceptual frameworks underlying potential mechanisms where value may be assessed. To address this gap, this article proposes a framework that builds on the large body of literature on quality of hospital care and the classic structure-process-outcome paradigm. The framework was also informed by the literature on adoption of technological innovations and introduces 2 distinct though related aspects of imaging technology not previously addressed specifically in the literature on quality of hospital care: adoption (a structural hospital characteristic) and use (an attribute of the process of care). The framework hypothesizes a 2-part causality where adoption is proposed to be a central, linking factor between hospital structural characteristics, market factors, and hospital outcomes (ie, quality and efficiency). The first part indicates that hospital structural characteristics and market factors influence or facilitate the adoption of high technology medical imaging within an institution. The presence of this technology, in turn, is hypothesized to improve the ability of the hospital to deliver high quality and efficient care. The second part describes this ability throughout 3 main mechanisms pointing to the importance of imaging use on patients, to the presence of staff and qualified care providers, and to some elements of organizational capacity capturing an enhanced clinical environment. The framework has the potential to assist empirical investigations of the value of adoption and use of medical imaging, and to advance understanding of the mechanisms that produce quality and efficiency in hospitals.

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Intensive Education on Evidence-Based Evaluation of Syncope Increases Sudden Death Risk Stratification but Fails to Reduce Use of Neuroimaging

Sclafani¹,

My²,

Zacher³

et al. 2010

Arch Intern Med

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With intensive education, there was no decrease in neuroimaging, despite a low diagnostic yield. We were able to increase sudden death risk stratification using electrophysiologic studies without evidence of overuse of implantable device-based therapy. Intensive education allows increased adherence to guidelines for mortality reduction; however, further attempts to reduce the lower yield imaging will require methods other than education of hospital-based physicians.

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Assessing the Value of a Diagnostic Test

Cited by 5 publications

References 7 publications

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

Adoption of high technology medical imaging and hospital quality and efficiency: Towards a conceptual framework

Intensive Education on Evidence-Based Evaluation of Syncope Increases Sudden Death Risk Stratification but Fails to Reduce Use of Neuroimaging

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