Monitoring and analysis of outcome studies.
Monitoring technology appears to be advancing at a rare that exceeds our ability to assess its effectiveness. RCTs are often poorly designed and lacks statistical power. Even high-quality RCTs may not provide inferences that can be generalized across all patient populations. Alternative methods of technology assessment, such as closed claims analysis, meta-analysis, and statistical process control, also have limitations. PORTs using a standard model of combined techniques are beginning to solve some of the more common methodological problems. The future of technology assessment relies on the ability to conduct large-scale cohort studies from routine practice settings. In terms of intraoperative monitors, this may require production of a complete and valid database of all monitored variables that can compared to a complete and valid database of all monitored variables that can be compared to a complete and valid database of appropriate outcome indicators. National standard for collection of data need to be developed. At this time, professional societies should focus more on developing guidelines for technology assessment than on guidelines for technology utilization.
Lagasse
R S
RS
Department of Anesthesiology, Albert Einsten College of Medicine, Montefiore Medical Center, Bronx, New York, USA.
D015331:Cohort Studies; D003625:Data Collection / Q000592:standards; D005544:Forecasting; D017408:Guidelines as Topic; D006801:Humans; D007256:Information Systems; D007345:Insurance Claim Review; D013677:Medical Laboratory Science; D015201:Meta-Analysis as Topic; D016343:Monitoring, Intraoperative; D008991:Monitoring, Physiologic / Q000592:standards / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000592:standards / Q000706:statistics & numerical data; D011340:Problem Solving; D016032:Randomized Controlled Trials as Topic; D013673:Technology Assessment, Biomedical