title: Examining the use of comparative and cost-effectiveness analyses in radiology.
abstract: OBJECTIVE
  This article explores key principles of comparative effectiveness analysis--in particular, how radiologic comparative and cost-effectiveness studies differ from other clinical trials. Exemplary studies are reviewed to show how comparative effectiveness has been implemented in radiology and how future studies might be conducted. Finally, the article closes with a discussion of several additional key themes relevant to quality and value in clinical radiology going forward.
  
  
  CONCLUSIONS
  Comparative effectiveness is likely to require a paradigm shift in thinking within the discipline. For new radiologic applications to be accepted, we will need to show at least a significant change in treatment planning and at best a meaningful change in patient outcomes. This shift will require a forward-thinking approach to robust evidence generation for new imaging modalities or indications and the inclusion of other modes of value demonstration such as clinical decision support and intelligent data mining.
authors.affiliation: 1 Department of Radiology, Yale University School of Medicine, 333 Cedar St, PO Box 208042, New Haven, CT 06520-8042.
authors.forename: Alexander
authors.initials: A
authors.lastname: Goehler
authors.forename: G Scott
authors.initials: GS
authors.lastname: Gazelle
mesh_terms: D057186:Comparative Effectiveness Research / Q000379:methods*; D003198:Computer Simulation; D003362:Cost-Benefit Analysis / Q000191:economics* / Q000379:methods*; D003365:Costs and Cost Analysis / Q000191:economics / Q000379:methods; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D017048:Health Care Costs; D018803:Models, Economic; D011871:Radiology / Q000193:education*; D014481:United States
keywords: comparative effectiveness analysis; cost-effectiveness analysis; modeling; patient-related outcomes; value demonstration