Elsevier

Clinical Radiology

Volume 50, Issue 8, August 1995, Pages 513-518
Clinical Radiology

Measuring the effects of imaging: An evaluative framework

https://doi.org/10.1016/S0009-9260(05)83184-8Get rights and content

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      An evaluative framework therefore must decide whether the test identifies the abnormalities, makes a diagnosis, displaces or improves upon other tests, contributes to service delivery and improves on outcomes for the whole population. Not surprisingly, most diagnostic tests have good evidence for their “efficacy” but often very little on their impact or effectiveness [3]. Focusing purely on technical performance can lead to failure to address the bigger picture and to incorrect assumptions about the new test.

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      That is not to say that efficacy studies solely rely on reporting, it is but one part of a larger system of patient clinical examinations (blood tests, bacterial cultures, biopsies) that affect patient outcomes. Key points of the efficacy chart include the technical quality of the images which have the potential to affect reporting abilities,38 the CT report, the post report effect on altered patient therapeutic plans to improve mortality/morbidity, and final patient outcomes including changes to or new treatments, avoidance of surgery or other diagnostic tests, hospital stay, or abandonment of clinical treatment.17,39 The mean agreement rate of 90.6% (95% CI 88.1–90.8%) achieved by the candidates, for normal and abnormal CT head examinations in this study also equates acceptably to the variance in concordance and major/minor discordance rates in studies by McCarron21 and Erly.22

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