title: Operability of nuclear instruments for medical use in developing countries. A decision-analytic approach.
abstract: Nuclear technology in diagnostic medicine has become a world-wide phenomenon. One of the problems encountered in implementing this technology in developing countries is predicting the operability of nuclear instruments under local conditions of maintenance and use. Our approach to this problem employs an analytic method often applied in medical decision making, and which can be incorporated into schemes for evaluating the total diagnostic process which utilizes nuclear technology. A recent survey of nine types of nuclear instruments in medical use in eight countries in Southeast Asia provided comprehensive information on the application and maintenance of these instruments, as well as a detailed record of actual operability and use of these instruments over a six-month period. A multivariate statistical analysis for predicting the operability of these instruments was carried out with some of the survey data. Responses to a set of 14 potentially important attributes of instrument use and maintenance obtained from the survey data were used to estimate the posterior probabilities of an instrument being inoperable for more than a given total number of hours in the six-month period during which operability was required. The posterior probabilities were determined by means of both Bayesian and discriminant analysis and summarized in the form of receiver operating characteristic (ROC) curves. Among a number of possible interpretations of the results, the analysis suggests that attributes generally involving installation, documentation, environment, and personnel training appear to be particularly important in predicting the operability of the instruments surveyed.
mesh_terms: D003657:Decision Making; D003906:Developing Countries; D003933:Diagnosis; D004868:Equipment Failure; D009683:Nuclear Medicine / Q000295:instrumentation*; D011795:Surveys and Questionnaires