Evidence-based approach to the introduction of positron emission tomography in ontario, Canada.
OBJECTIVE
The uptake of new health care technologies is usually driven by industry promotion, physician interest, patient demand, and institutional ability to acquire the technology. The introduction of positron emission tomography (PET) scanning in the province of Ontario, Canada, followed a different path.


METHODS
The Ontario provincial government, through its Ministry of Health and Long-Term Care, commissioned a systematic review of the literature. When this found only weak evidence that PET has a positive impact on clinical outcomes, the Ministry introduced a provincial PET evaluation program to close the evidence gap.


RESULTS
This article describes the challenges encountered establishing the PET evaluation program. These included the design and conduct of the initial clinical trials, the establishment of a PET cancer registry, standardizing how PET scans were performed and reported, and gaining acceptance by health professionals for the evaluative program.


CONCLUSIONS
The proliferation of health technologies is a key driver of increasing health care costs. The Ontario approach to the introduction of PET is a model worth consideration by health systems seeking to ensure that they receive value for money based on a strong evidentiary base when introducing new health technologies.
Juravinski Cancer Centre at Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada. bill.evans@jcc.hhsc.ca
William K
WK
Evans
Andreas
A
Laupacis
Karen Y
KY
Gulenchyn
Les
L
Levin
Mark
M
Levine
D002986:Clinical Trials as Topic; D019317:Evidence-Based Medicine / Q000191:economics; D005260:Female; D005544:Forecasting; D017048:Health Care Costs; D006285:Health Planning / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000592:standards / Q000639:trends; D009313:National Health Programs / Q000458:organization & administration; D009864:Ontario; D049268:Positron-Emission Tomography / Q000191:economics / Q000706:statistics & numerical data*; D012042:Registries