Methodological considerations in the assessment of noninvasive testing using outcomes research: pitfalls and limitations.
The ongoing demands for cost-containment in medicine have radically altered the practice of medicine in general and the practice of cardiology in particular. The need to justify the use of noninvasive testing has led to the development of outcomes data to validate the use of these tests and show their cost-effectiveness when incorporated into testing strategies. The development of a supportive literature of noninvasive modalities, however, requires an understanding of the varied methodological approaches that constitute outcomes research. The proper use of these methods, the interpretation of their results, and the application of these results to clinical practice are potentially problematic. This review focuses on the use and limitations of the methods used for outcomes-based assessment of technology and examples of their application.
Hachamovitch
R
R
Emory Center for Outcomes Research, Emory University, Atlanta, GA, USA.
Shaw
L
L
Berman
D S
DS
D003362:Cost-Benefit Analysis; D003935:Diagnostic Techniques, Cardiovascular; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D018803:Models, Economic; D017202:Myocardial Ischemia / Q000175:diagnosis*; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D018570:Risk Assessment / Q000191:economics / Q000379:methods