Epidemiologic methodology in evaluating health technology.
Epidemiologic methods provide a basis for evaluating new medical technologies of varying complexity and sophistication. Use is made of the concepts of efficacy, effectiveness and efficiency, and cost-effectiveness. The available methods, observational and experimental, are reviewed in the context of evaluation of the intensive coronary care unit (ICCU). Most early studies that showed a benefit in low in-hospital case fatality rates for patients with myocardial infarction in the ICCU had serious flaws in design and analysis. Better studies failed to show any benefit, and some showed an increase in the case fatality rates in the ICCU when compared with the medical wards or even with patients treated at home (for noncomplicated infarctions). Most recent studies have attempted to predict which patients should and which should not be admitted to the ICCU, in order to improve efficiency.
D003325:Coronary Care Units; D004812:Epidemiologic Methods; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy; D013673:Technology Assessment, Biomedical / Q000379:methods*