Accuracy, Risk and the Intrinsic Value of Diagnostic Imaging

Otero, Hansel J.; Fang, Chi H.; Sekar, Meera; Ward, Robert James; Neumann, Peter J.

doi:10.1016/j.acra.2012.01.011

Cited by 8 publications

(3 citation statements)

References 41 publications

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“…In the Brazilian review, five out of 12 cost-effectiveness studies reviewed and the only CUA varied in the accuracy measurements used in the sensitivity analysis. It should be stressed that this finding should be 100% 8 .…”

Section: Discussionmentioning

confidence: 81%

Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?

Oliveira

Leandro

Decimoni

et al. 2017

Clinics

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The aim of this study is to identify and characterize the health economic evaluations (HEEs) of diagnostic tests conducted in Brazil, in terms of their adherence to international guidelines for reporting economic studies and specific questions in test accuracy reports. We systematically searched multiple databases, selecting partial and full HEEs of diagnostic tests, published between 1980 and 2013. Two independent reviewers screened articles for relevance and extracted the data. We performed a qualitative narrative synthesis. Forty-three articles were reviewed. The most frequently studied diagnostic tests were laboratory tests (37.2%) and imaging tests (32.6%). Most were non-invasive tests (51.2%) and were performed in the adult population (48.8%). The intended purposes of the technologies evaluated were mostly diagnostic (69.8%), but diagnosis and treatment and screening, diagnosis, and treatment accounted for 25.6% and 4.7%, respectively. Of the reviewed studies, 12.5% described the methods used to estimate the quantities of resources, 33.3% reported the discount rate applied, and 29.2% listed the type of sensitivity analysis performed. Among the 12 cost-effectiveness analyses, only two studies (17%) referred to the application of formal methods to check the quality of the accuracy studies that provided support for the economic model. The existing Brazilian literature on the HEEs of diagnostic tests exhibited reasonably good performance. However, the following points still require improvement: 1) the methods used to estimate resource quantities and unit costs, 2) the discount rate, 3) descriptions of sensitivity analysis methods, 4) reporting of conflicts of interest, 5) evaluations of the quality of the accuracy studies considered in the cost-effectiveness models, and 6) the incorporation of accuracy measures into sensitivity analyses.

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Section: Discussionmentioning

confidence: 81%

Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?

Oliveira

Leandro

Decimoni

et al. 2017

Clinics

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“…To see is better than not to see, or not to know. E. g., imaging technologies have intrinsic values [35]. We tend to need more and better evidence to call a halt on a technology (disinvestment) than to implement one, and “loss aversion,” “stakeholder inertia”, “entrenchment” has been identified in health technology management [8].…”

Section: General Values In Htamentioning

confidence: 99%

Health Technology Assessment – science or art?

Hofmann

2013

GMS Health Technology Assessment; 9:Doc08; ISSN 1861-8863

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“…[20][21][22][23] Similarly, the selection of patients in whom the test is performed, the consequences of incidental findings (also referred to as chance findings), and the occurrence of test failures or indeterminate test results are often not reported. [24][25][26] Although simplifications of the decision-analytic models used for such evaluations may sometimes be necessary and can be adequately justified, implicit simplification due to unawareness of all relevant evaluation aspects or without proper justification may lead to nontransparent and incorrect evaluation results.…”

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confidence: 99%

Toward Alignment in the Reporting of Economic Evaluations of Diagnostic Tests and Biomarkers: The AGREEDT Checklist

et al. 2018

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Objectives. General frameworks for conducting and reporting health economic evaluations are available but not specific enough to cover the intricacies of the evaluation of diagnostic tests and biomarkers. Such evaluations are typically complex and model-based because tests primarily affect health outcomes indirectly and real-world data on health outcomes are often lacking. Moreover, not all aspects relevant to the evaluation of a diagnostic test may be known and explicitly considered for inclusion in the evaluation, leading to a loss of transparency and replicability. To address this challenge, this study aims to develop a comprehensive reporting checklist. Methods. This study consisted of 3 main steps: 1) the development of an initial checklist based on a scoping review, 2) review and critical appraisal of the initial checklist by 4 independent experts, and 3) development of a final checklist. Each item from the checklist is illustrated using an example from previous research. Results. The scoping review followed by critical review by the 4 experts resulted in a checklist containing 44 items, which ideally should be considered for inclusion in a model-based health economic evaluation. The extent to which these items were included or discussed in the studies identified in the scoping review varied substantially, with 14 items not being mentioned in ≥47 (75%) of the included studies. Conclusions. The reporting checklist developed in this study may contribute to improved transparency and completeness of model-based health economic evaluations of diagnostic tests and biomarkers. Use of this checklist is therefore encouraged to enhance the interpretation, comparability, and—indirectly—the validity of the results of such evaluations.

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Accuracy, Risk and the Intrinsic Value of Diagnostic Imaging

Cited by 8 publications

References 41 publications

Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?

Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?

Health Technology Assessment – science or art?

Toward Alignment in the Reporting of Economic Evaluations of Diagnostic Tests and Biomarkers: The AGREEDT Checklist

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