title: Cost-effectiveness modelling in diagnostic imaging: a stepwise approach.
abstract: Diagnostic imaging (DI) is the fastest growing sector in medical expenditures and takes a central role in medical decision-making. The increasing number of various and new imaging technologies induces a growing demand for cost-effectiveness analysis (CEA) in imaging technology assessment. In this article we provide a comprehensive framework of direct and indirect effects that should be considered for CEA in DI, suitable for all imaging modalities. We describe and explain the methodology of decision analytic modelling in six steps aiming to transfer theory of CEA to clinical research by demonstrating key principles of CEA in a practical approach. We thereby provide radiologists with an introduction to the tools necessary to perform and interpret CEA as part of their research and clinical practice.
  
  
  CONCLUSIONS
  • DI influences medical decision making, affecting both costs and health outcome. • This article provides a comprehensive framework for CEA in DI. • A six-step methodology for conducting and interpreting cost-effectiveness modelling is proposed.
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P.O. Box 5800, P.Debyelaan 25, Maastricht, 6202 AZ, The Netherlands. anni.sailer@mumc.nl.|Department of Radiology, Stanford University Hospitals and Clinics, Stanford, CA, USA. anni.sailer@mumc.nl.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Sailer
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P.O. Box 5800, P.Debyelaan 25, Maastricht, 6202 AZ, The Netherlands.
authors.forename: Wim H
authors.initials: WH
authors.lastname: van Zwam
authors.affiliation: Department of Radiology, Maastricht University Medical Center, P.O. Box 5800, P.Debyelaan 25, Maastricht, 6202 AZ, The Netherlands.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, P.O. Box 9101, Geert Grooteplein-Zuid 10, Nijmegen, 6500 HB, The Netherlands.
authors.forename: Janneke P C
authors.initials: JP
authors.lastname: Grutters
mesh_terms: D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003952:Diagnostic Imaging / Q000191:economics*; D006801:Humans; D013673:Technology Assessment, Biomedical / Q000191:economics*
keywords: Cost Effectiveness; Decision Modelling; Diagnostic Imaging; Economics; Technology Assessment