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Semin Musculoskelet Radiol 2017; 21(01): 037-042
DOI: 10.1055/s-0036-1597254
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Using Cost-Effectiveness Analysis to Measure Value in Musculoskeletal Imaging

Jacob J. Visser
1   Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
,
Edwin H. G. Oei
1   Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
,
M. G. Myriam Hunink
1   Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
2   Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
3   Center for Health Decision Science, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
› Author Affiliations
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Publication History

Publication Date:
02 March 2017 (online)

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Abstract

In the era of value-based health care, adding value is a key element in providing care. The choice of appropriate imaging modality and protocol should be based on consideration of patients’ values, health care outcomes, and cost-effectiveness, taking into account the perspective of the decision maker, the health care system, and society at large. This article provides an overview of the available tools to measure value, outcomes, and cost-effectiveness in musculoskeletal radiology, illustrated with relevant examples.

Keywords

value-based health care - outcomes - musculoskeletal radiology - medical decision making - cost-effectiveness analysis
 

  • References

  • 1 Michael Porter EOT. Redefining Health Care. Cambridge, MA: Harvard Business School Press; 2006
    Google Scholar
  • 2 Porter ME. What is value in health care?. N Engl J Med 2010; 363 (26) 2477-2481
    CrossrefPubMedGoogle Scholar
  • 3 Dinan MA, Curtis LH, Hammill BG. , et al. Changes in the use and costs of diagnostic imaging among Medicare beneficiaries with cancer, 1999–2006. JAMA 2010; 303 (16) 1625-1631
    CrossrefPubMedGoogle Scholar
  • 4 Yabroff KR, Lund J, Kepka D, Mariotto A. Economic burden of cancer in the United States: estimates, projections, and future research. Cancer Epidemiol Biomarkers Prev 2011; 20 (10) 2006-2014
    CrossrefPubMedGoogle Scholar
  • 5 International Consortium for Health Outcomes Measurement. Available at: http://www.ichom.org/ . Accessed July 6, 2016
    PubMedGoogle Scholar
  • 6 Ferrante di Ruffano L, Hyde CJ, McCaffery KJ, Bossuyt PM, Deeks JJ. Assessing the value of diagnostic tests: a framework for designing and evaluating trials. BMJ 2012; 344: e686
    CrossrefPubMedGoogle Scholar
  • 7 Boland GW, Duszak Jr R, McGinty G, Allen Jr B. Delivery of appropriateness, quality, safety, efficiency and patient satisfaction. J Am Coll Radiol 2014; 11 (01) 7-11
    CrossrefPubMedGoogle Scholar
  • 8 Hunink MGM, Weinstein MC, Witteberg E. , et al. Decision Making in Health and Medicine: Integrating Evidence and Values. Cambridge, UK: Cambridge University Press; 2014
    Google Scholar
  • 9 Sekhar MS, Vyas N. Defensive medicine: a bane to healthcare. Ann Med Health Sci Res 2013; 3 (02) 295-296
    CrossrefPubMedGoogle Scholar
  • 10 Kind P, Lafata JE, Matuszewski K, Raisch D. The use of QALYs in clinical and patient decision-making: issues and prospects. Value Health 2009; 12 (Suppl. 01) S27-S30
    CrossrefPubMedGoogle Scholar
  • 11 EuroQol Group. EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (03) 199-208
    CrossrefPubMedGoogle Scholar
  • 12 Brooks R. EuroQol: the current state of play. Health Policy 1996; 37 (01) 53-72
    CrossrefPubMedGoogle Scholar
  • 13 Johannesson M, O'Conor RM. Cost-utility analysis from a societal perspective. Health Policy 1997; 39 (03) 241-253
    CrossrefPubMedGoogle Scholar
  • 14 Porter ME, Larsson S, Lee TH. Standardizing patient outcomes measurement. N Engl J Med 2016; 374 (06) 504-506
    CrossrefPubMedGoogle Scholar
  • 15 Nikken JJ, Oei EH, Ginai AZ. , et al. Acute peripheral joint injury: cost and effectiveness of low-field-strength MR imaging—results of randomized controlled trial. Radiology 2005; 236 (03) 958-967
    CrossrefPubMedGoogle Scholar
  • 16 Vincken PW, ter Braak AP, van Erkel AR. , et al. MR imaging: effectiveness and costs at triage of patients with nonacute knee symptoms. Radiology 2007; 242 (01) 85-93
    CrossrefPubMedGoogle Scholar
  • 17 Oei EH, Nikken JJ, Ginai AZ. , et al. Costs and effectiveness of a brief MRI examination of patients with acute knee injury. Eur Radiol 2009; 19 (02) 409-418
    CrossrefPubMedGoogle Scholar
  • 18 Parker L, Nazarian LN, Carrino JA. , et al. Musculoskeletal imaging: medicare use, costs, and potential for cost substitution. J Am Coll Radiol 2008; 5 (03) 182-188
    CrossrefPubMedGoogle Scholar
  • 19 Yun BJ, Myriam Hunink MG, Prabhakar AM. , et al. Diagnostic imaging strategies for occult hip fractures: a decision and cost-effectiveness analysis. Acad Emerg Med 2016; 23 (10) 1161-1169
    CrossrefPubMedGoogle Scholar
  • 20 Hunink MG. Decision making in the face of uncertainty and resource constraints: examples from trauma imaging. Radiology 2005; 235 (02) 375-383
    CrossrefPubMedGoogle Scholar
  • 21 Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL. Methods for the Economic Evaluation of Health Care Programmes. 3rd ed. Oxford, UK: Oxford University Press; 2015
    Google Scholar
  • 22 Gold M, Siegel JE, Russell LB, Weinstein MC. Cost-Effectiveness in Health and Medicine. Oxford, UK: Oxford University Press; 1996
    Google Scholar
  • 23 Redelmeier DA, Heller DN. Time preference in medical decision making and cost-effectiveness analysis. Med Decis Making 1993; 13 (03) 212-217
    CrossrefPubMedGoogle Scholar
  • 24 Briggs AH, Ades AE, Price MJ. Probabilistic sensitivity analysis for decision trees with multiple branches: use of the Dirichlet distribution in a Bayesian framework. Med Decis Making 2003; 23 (04) 341-350
    CrossrefPubMedGoogle Scholar
  • 25 Groot Koerkamp B, Nikken JJ, Oei EH, Stijnen T, Ginai AZ, Hunink MG. Value of information analysis used to determine the necessity of additional research: MR imaging in acute knee trauma as an example. Radiology 2008; 246 (02) 420-425
    CrossrefPubMedGoogle Scholar
  • 26 Claxton K. The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies. J Health Econ 1999; 18 (03) 341-364
    CrossrefPubMedGoogle Scholar
  • 27 Houseman J, Andrews-Dickert R. The sensitivity of conventional radiography in acute knee trauma. Trauma. 2016 ; July 6 (Epub ahead of print)
    PubMedGoogle Scholar
  • 28 Chambers SB. , et al. Sensitivity of magnetic resonance imaging in detecting meniscal pathology. Br J Sports Med 2010; 44 (14) i5-i6
    PubMedGoogle Scholar
  • 29 Jarraya M, Hayashi D, Roemer FW. , et al. Radiographically occult and subtle fractures: a pictorial review. Radiol Res Pract 2013; 2013: 370169
    PubMedGoogle Scholar
  • 30 Health knowledge. Available at: http://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4d-health-economics/economic-appraisal . Accessed September 7, 2016
    PubMedGoogle Scholar