Assessment of diagnostic technology in health care : rationale, methods, problems, and directions / / Harold Sox ... [et al.]

• Record Nr.: UNINA9910962419803321
• Pubbl/distr/stampa: Washington, D.C., : National Academy Press, 1989
• ISBN: 9786610214181; 9781280214189; 128021418X; 9780309535885; 0309535883; 9780585001920; 0585001928
• Edizione: [1st ed.]
• Descrizione fisica: 1 online resource (152 p.)
• Collana: Monograph of the Council on Health Care Technology
• Altri autori (Persone): SoxHarold C
• Disciplina: 616.075
• Soggetti: Diagnosis - Methodology - Evaluation; Medical technology - Evaluation
• Lingua di pubblicazione: Inglese
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Note generali: Description based upon print version of record.
• Nota di bibliografia: Includes bibliographical references.
• Nota di contenuto: ""Assessment of Diagnostic Technology in Health Care""; ""Copyright""; ""Preface""; ""Contents""; ""Introduction""; ""REFERENCES""; ""1 Rationale for Assessment of Diagnostic Technology""; ""THE PATIENT'S PERSPECTIVE""; ""Safety""; ""Efficacy""; ""Economic Issues""; ""The Benefits of High-Quality Studies""; ""The Risks of Poor or Absent Assessment Data""; ""Summary: The Patient's Perspective""; ""SOCIETY'S PERSPECTIVE""; ""Safety and Efficacy""; ""Economic Issues""; ""Summary: Society's Perspective""; ""THE PHYSICIAN'S PERSPECTIVE""; ""Safety and Efficacy""; ""Economic Issues""; ""Summary: The Physician's Perspective""""SUMMARY""; ""REFERENCES""; ""2 The Use of Diagnostic Tests: A Probabilistic Approach""; ""FIRST PRINCIPLES""; ""INTERPRETING TEST RESULTS: THE POSTTEST PROBABILITY""; ""Important Definitions""; ""The Assumptions of Bayes' Theorem""; ""THE PRETEST PROBABILITY OF DISEASE""; ""MEASURING THE PERFORMANCE CHARACTERISTICS OF DIAGNOSTIC TESTS""; ""Designing Studies of Test Performance""; ""EXPECTED-VALUE ; DECISIONMAKING""; ""Setting Up the Decision Tree""; ""Weighing the Outcomes for Quality of Life""; ""Calculating the Expected Value of the Treatment Options""""THE CHOICE AMONG DOING NOTHING, TESTING, OR STARTING TREATMENT""; ""SUMMARY""; ""Glossary Of Terms""; ""REFERENCES""; ""3 Assessment: Problems and Proposed Solutions""; ""MEASURES OF CLINICAL EFFICACY""; ""Technical Capability""; ""Sensitivity and Specificity""; ""Diagnostic Impact""; ""Therapeutic Impact""; ""Impact on Clinical Outcomes""; ""THE SYSTEM OF TECHNOLOGY ASSESSMENT IN THE UNITED STATES""; ""The Pyramid""; ""PROBLEMS WITH THE CURRENT SYSTEM""; ""RANDOMIZED TRIALS OF DIAGNOSTIC TESTS""; ""Limitations of Randomized Trials""""Trial Design""; """"OFF THE GOLD STANDARD""""; """"ON THE GOLD STANDARD""""; ""A PROPOSAL FOR MODEL-DRIVEN TECHNOLOGY ASSESSMENT""; ""A Technology Should Be Compared with a Competing Technology""; ""STUDIES SHOULD BE PLANNED BEFORE ENROLLING THE FIRST PATIENT""; ""ALL THE DATA THAT ARE NEEDED FOR CLINICAL DECISION MAKING SHOULD BE COLLECTED""; ""BIAS IN PATIENT SELECTION SHOULD BE AVOIDED""; ""PATIENTS SHOULD BE OBSERVED FOR ADVERSE EFFECTS OF THE INDEX TEST""; ""INTERPRETATION OF DATA SHOULD BE FREE OF BIAS""; ""INTEROBSERVER DISAGREEMENT SHOULD BE MEASURED""""THERE SHOULD BE ENOUGH PATIENTS TO REPORT THE RESULTS IN CLINICALLY USEFUL SUBGROUPS OF PATIENTS""; ""SUMMARY""; ""REFERENCES""; ""4 Primary Assessment of Diagnostic Tests: Barriers to Implementation""; ""PLANNING AND PROTOCOL DEVELOPMENT""; ""Choosing a Clinical Condition""; ""Patient Population""; ""Endpoints and Study Design""; ""ACCURACY""; ""OUTCOME""; ""COMBINED STUDIES: ACCURACY AND OUTCOME""; ""SHORT-TERM OUTCOMES: A SYNTHETIC APPROACH""; ""Economic Analysis""; ""Efficacy Versus Effectiveness""; ""Comparative Assessment""; ""Sample Size""