Skip to main content
SpringerLink
Log in

Technology Assessment

  • Chapter
Epidemiology and the Delivery of Health Care Services

  • 261 Accesses

Summary

Who should ultimately decide what is standard therapy,state-of-the-art, or investiga- tional: juries, judges, politicians, scientists, providers,patients, or payers? This question has no clear answer. This chapter strongly recommends that health care administrators, providers, and payers should all be familiar with the elements of technology assessment as a means of monitoring the quality and cost-effectiveness of health care delivery and should utilize epidemiological information, particularly on utilization trends and studies of risks versus benefits of new technologies. Future health care administrators, as important decision makers in new technology acquisition, must possess a comprehensive understanding of the issues involved in the process of technology assessment as well as the ability to interpret the primary medical literature knowledgeably, using epidemiological methods to assess the relative merits and limitations of new technologies. In this way, proactive technology decisions will be made, not reactive decisions based on external pressures.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • American College of Obstetricians and Gynecologists, 1988, New Guidelines for VBAC: Statement of the Committee on Obstetrics: Maternal and Fetal Medicine, ACOG, Washington, DC.

    Google Scholar 

  • American Medical Association, Council on Scientific Affairs, 1988, Application of positron emission tomography in the heart, JAMA 16:2438–2445.

    Google Scholar 

  • American Society of Health-System Pharmacists, 1999, American Hospital Formulary Service—Drug Information, Author, Bethesda, MD.

    Google Scholar 

  • Anderson, G. F, Hall, M. A., and Steinberg, E. P., 1993, Medical technology assessment and practice guidelines: Their day in court, Am. J. Pub. Health 83:1635–1639.

    PubMed  CAS  Google Scholar 

  • Antiplatelet Trialists’ Collaboration, 1994, Collaborative overview of randomized trials of antiplatelet therapy—I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patient, Br. Med. J. 308:81–106.

    Google Scholar 

  • Appleby, C. R., 1991, HCFA told to cover lenses still in clinical trial, HealthWeek 5:4.

    Google Scholar 

  • Aubuchon, J. P., and Birkmeyer, J. D., 1994, Safety and cost-effectiveness of solvent-detergent-treated plasma: In search of a zero-risk blood supply, JAMA 272:1210–1214.

    Article  PubMed  CAS  Google Scholar 

  • Bailar, J. C., III, 1997, The promise and problems of meta-analysis, N. Engl. J. Med. 337:559–561.

    Article  PubMed  Google Scholar 

  • Bailar, J. C., III, and Mosteller, F., 1988, Guidelines for statistical reporting in articles for medical journals, Ann. Intern. Med. 108:266–273.

    PubMed  Google Scholar 

  • Banta, H. D., and Thacker, S. B., 1990, The case for reassessment of health care technology: Once is not enough, JAMA 264:235–240.

    Article  PubMed  CAS  Google Scholar 

  • Blue Cross and Blue Shield Association, Technology Evaluation Center, 1997, TEC Criteria, The Association, Chicago, IL.

    Google Scholar 

  • Bootman, J. L., Townsend, R. J., and McGhan, W. F. (eds.), 1996, Principles of Pharmacoeconomics, 2nd ed., Harvey Whitney Books, Cincinnati, OH.

    Google Scholar 

  • Braitman, L. E., 1991, Confidence intervals assess both clinical significance and statistical significance, Ann. Intern. Med. 114:515–517.

    PubMed  CAS  Google Scholar 

  • Brown, W. S., and Newman, T. B., 1987, Are all significant p values created equal? The analogy between diagnostic tests and clinical research, JAMA 257:2459–2463.

    Google Scholar 

  • Calltorp, J., and Smedby, B., 1989, Technology assessment activities in Sweden, Int. J. Technol. Assess. Health Care 5:263–297.

    PubMed  CAS  Google Scholar 

  • [The] CAPTURE Investigators, 1997, Randomised placebo-controlled trial of abciximab before and during coronary intervention in refractory unstable angina: The CAPTURE study, Lancet 349:1429–1435.

    Google Scholar 

  • Chalmers, T. C., Smith, H., Jr., Blackburn, B., Silverman, B., Schroeder, B., Reitman, D., and Abroz, A., 1981, A method for assessing the quality of a randomized control trial, Control. Clin. Trials 2:31–49.

    PubMed  CAS  Google Scholar 

  • Chen, C., Danekas, L. H., Ratko, T. A., Vlasses, P. H., and Matuszewski, K. A., 2000, A multicenter drug use surveillance of intravenous immunoglobulin utilization in US academic health centers, Ann. Pharmacother. 34: 295–299.

    Article  PubMed  CAS  Google Scholar 

  • Cochrane Injuries Group Albumin Reviewers, 1998, Human albumin administration in critically ill patients: Systematic review of randomised controlled trials—Why albumin may not work, Br. Med. J. 317:235–240.

    Google Scholar 

  • Connors, A. F, Speroff, T., Dawson, N. V., Thomas, C., Harrell, F. E., Wagner, D., Desbiens, N., Goldman, L., Wu, A. W., Califf, R. M., Fulkerson, W. J., Vidaillet, H., Broste, S., Bellamy, P., Lynn, J., and Knaus, W., for the SUPPORT Investigators, 1996, The effectiveness of right heart catheterization in the initial care of critically ill patients, JAMA 276:889–897.

    Article  PubMed  Google Scholar 

  • Davis, K., 1990, Use of data registries to evaluate medical procedures, Int. J. Technol. Assess. Health Care 6:203–210.

    PubMed  CAS  Google Scholar 

  • Detsky, A. S., 1989, Are clinical trials a cost-effective investment? JAMA 262:1795–1800.

    Article  PubMed  CAS  Google Scholar 

  • Detsky, A. S., and Naglie, I. G., 1990, A clinician’s guide to cost-effectiveness analysis, Ann. Intern. Med. 113: 147–154.

    PubMed  CAS  Google Scholar 

  • Diamond, G. A., and Denton, T. A., 1993, Alternative perspectives on the biased foundations of medical technology assessment, Ann. Intern. Med. 118:455–464.

    PubMed  CAS  Google Scholar 

  • Eddy, D. M., 1989, Selecting technologies for assessment, Int. J. Technol. Assess. Health Care 5:485–501.

    PubMed  CAS  Google Scholar 

  • Eddy, D. M., 1997, Breast cancer screening in women younger than 50 years of age: What’s next? Ann. Intern. Med. 127:1035–1036.

    PubMed  CAS  Google Scholar 

  • Ferguson, J. H., Dubinsky, M., and Kirsch, P. J., 1993, Court-ordered reimbursement for unproven medical technology: Circumventing technology assessment, JAMA 269:2116–2121.

    Article  PubMed  CAS  Google Scholar 

  • Fuchs, V. R., and Garber, A. M., 1990, The new technology assessment, N. Engl. J. Med. 323:673–677.

    PubMed  CAS  Google Scholar 

  • Gelijns, A. C., and Rigter, H., 1990, Health care technology assessment in the Netherlands, Int. J. Technol. Assess. Health Care 6:157–174.

    PubMed  CAS  Google Scholar 

  • Gill, T. M., and Feinstein, A. R., 1994, A critical appraisal of the quality of quality-of-life measurements, JAMA 272:619–626.

    Article  PubMed  CAS  Google Scholar 

  • Gold, M. R., Siegel, J. E., Russell, L. B., and Weinstein, M. C. (eds.), 1996, Cost-Effectiveness in Health and Medicine, Oxford University Press, Oxford, England.

    Google Scholar 

  • Greenland, S., 1989, Modeling and variable selection in epidemiologic analysis, Am. J. Publ. Health 79:340–349.

    Article  CAS  Google Scholar 

  • Gross, P. F., 1989, Technology assessment in health care in Australia, Int. J. Technol. Assess. Health Care 5:137–153.

    PubMed  CAS  Google Scholar 

  • Hodge, J. G., Gostin, L. O., and Jacobson, P. D., 1999, Legal issues concerning electronic health information: Privacy, quality, and liability, JAMA 282:1466–1471.

    Article  PubMed  Google Scholar 

  • Hooper, D. C., and Wolfson, J. S., 1991, Fluoroquinolone antimicrobial agents, N. Engl. J. Med. 324:384–394.

    PubMed  CAS  Google Scholar 

  • Institute of Medicine, Council on Health Care Technology, 1990, National Priorities for the Clinical Conditions and Medical Technologies, Report of a Pilot Study, National Academy Press, Washington, DC.

    Google Scholar 

  • [The] Ischemic Optic Neuropathy Decompression Trial Research Group, 1995, Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful, JAMA 273:625–632.

    Google Scholar 

  • Katerndahl, D. A., and Lawler, W. R., 1999, Variability in meta-analytic results concerning the value of cholesterol reduction in coronary heart disease: A meta-meta-analysis, Am. J. Epidemiol. 149:429–441.

    PubMed  CAS  Google Scholar 

  • Koch, P. W., 1987, Government reimbursement policy and medical technology assessment: The case of Switzerland, Int. J. Technol. Assess. Health Care 3:607–612.

    PubMed  CAS  Google Scholar 

  • Kohn, L., Corrigan, J., and Donaldson, M. (eds.), 1999, To Err Is Human: Building a Safer Health System, National Academy Press, Washington, DC.

    Google Scholar 

  • Larson, E. B., and Kent, D. L., 1989, The relevance of socioeconomic and health policy issues to clinical research, Int. J. Technol. Assess. Health Care 5:195–206.

    PubMed  CAS  Google Scholar 

  • Laupacis, A. L., Sackett, D. L., and Roberts, R. S., 1988, An assessment of clinically useful measures of the consequence of treatment, N. Engl. J. Med. 318:1728–1733.

    Article  PubMed  CAS  Google Scholar 

  • Laupacis, A., Feeny, D., Detsky, A. S., and Tugwell, P. X., 1992, How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations. Can. Med. Assoc. J. 146:473–481.

    CAS  Google Scholar 

  • Leape, L., 1989, Unnecessary surgery, Health Serv. Res. 23:351–407.

    Google Scholar 

  • LeGales, C., and Moatt, J. P., 1990, Searching for consensus through multicriteria decision analysis: Assessment of screening strategies for hemoglobinopathies in southeastern France, Int. J. Technol. Assess. Health Care 6 : 430–449.

    CAS  Google Scholar 

  • MacDonald, D., Grant, A., Sheridan-Pereira, M., Boylan, P., and Chalmers, I., 1985, The Dublin randomized controlled trial of intrapartum fetal heart rate monitoring, Am. J. Obstet. Gynecol. 152:524–539.

    PubMed  CAS  Google Scholar 

  • Matuszewski, K., and Vermeulen, L., 1994, Medical technology assessment, in Critical Issues Shaping Medical Practice, University Hospital Consortium, Oakbrook, IL.

    Google Scholar 

  • McGivney, W. T, and Hendee, W. R., 1990, Regulation, coverage, and reimbursement of medical technologies, Int. J. Radial. Oncol. Biol. Phys. 18:697–700.

    CAS  Google Scholar 

  • Mosby-Year Book, Inc., 1996, Physicians GenRx, St. Louis, MO.

    Google Scholar 

  • Murphy, J. R., 1991, The assessment process: A microscopic view, Med. Prog. Technol. 17:77–83.

    PubMed  CAS  Google Scholar 

  • National Institutes of Health, 1990, Intravenous Immunoglobulin: Consensus Statement 8, No. 5, NIH, Bethesda, MD.

    Google Scholar 

  • Office of Technology Assessment, 1976, Development of Medical Technology: Opportunities for Assessment, US Government Printing Office, Washington, DC.

    Google Scholar 

  • Ozminkowski, R. J., Wortman, P., and Roloff, D., 1987, Evaluating the effectiveness of neonatal intensive care: What can the literature tell us? Am. J. Perinatol. 4:339–347.

    Article  PubMed  CAS  Google Scholar 

  • Park, R. E., Fink, A., Brook, R. H., Chassin, M. R., Kahn, K. L., Merrick, N. J., Kosecoff, J., and Solomon, D. H., 1986, Physician ratings of appropriate indications for six medical and surgical procedures. Am. J. Public Health 76:766–772.

    PubMed  CAS  Google Scholar 

  • Perry, S., and Thamer, M., 1999, Medical innovation and the critical role of health technology assessment, JAMA 282:1869–1872.

    Article  PubMed  CAS  Google Scholar 

  • Perry, S., Hanft, R., and Chrzanowski, R., 1991, Technology assessment reports. Int. J. Technol. Assess. Health Care 7:68–105.

    Google Scholar 

  • Perry, S., Garder, E. M., and Hong, R., 1998, Directory of Health Technology Assessment Organizations Worldwide, Medical Terminology and Practice Patterns Institute Press, Washington, D.C.

    Google Scholar 

  • Radensky, P., 1991, Federal activities related to health and economic outcomes, Administrative Radiology 54:53–55.

    Google Scholar 

  • Ratko, T. A., Burnett, D. A., Foulke, G. E., Matuszewski, K. A., and Sacher, R. A., 1995, Recommendations for offlabel use of intravenously administered immunoglobulin preparations, JAMA 273:1865–1870.

    Article  PubMed  CAS  Google Scholar 

  • Ries, L. A. G., Eisner, M. P., Kosary, C. L., Hankey, B. F., Miller, B. A., Clegg, L., and Edwards, B. K. eds., 2000, SEER Cancer Statistics Review, 1973–1997, National Cancer Institute, Bethesda, MD.

    Google Scholar 

  • Rettig, R. A., 1997, Health Care in Transition: Technology Assessment in the Private Sector, Rand, Santa Monica, CA.

    Google Scholar 

  • Rimm, A. A., Barr, J. T, Horowitz, M. M., and Bortin, M. M., 1991, Use of a clinical data registry to evaluate medical technologies. Int. J. Technol. Assess. Health Care 7:182–193.

    Article  PubMed  CAS  Google Scholar 

  • Rodenhuis, S., Richel, D. J., van der Wall, E., Schornagel, J. H., Baars, J. W., Koning, C. C., Peterse, J. L., Barger, J. H., Nooijen, W. J., Bakx, R., Dalesio, O., and Rutgers, E., 1998, Randomised trial of high-dose chemotherapy and haemopoietic progenitor-cell support in operable breast cancer with extensive axillary lymph-node involvement. Lancet 352:515–521.

    PubMed  CAS  Google Scholar 

  • Schwartz, J. S., and Lurie, N., 1990, Assessment of medical outcomes: New opportunities for achieving a long sought-after objective, Int. J. Technol. Assess. Health Care 6:333–339.

    PubMed  CAS  Google Scholar 

  • Schwartz, W. B., 1987, The inevitable failure of current cost-containment strategies, JAMA 257:220–224.

    PubMed  CAS  Google Scholar 

  • Shulkin, D. J., Ratko, T. A., and Matuszewski, K. A., 1996, Model guidelines for the preoperative evaluation of patients undergoing elective surgery, J. Clin. Outcomes Manage. 3:39–48.

    Google Scholar 

  • Shy, K. K., Luthy, D. A., Bennett, F. C., Whitfield, M., Larson, E. B., van Belle, G., Hughes, J. P., Wilson, J. A., and Stenchever, M. A., 1990, Effects of electronic fetal heart rate monitoring, as compared with periodic auscultation, on the neurologic development of premature infants, N. Engl. J. Med. 322:588–593.

    Article  PubMed  CAS  Google Scholar 

  • Steinbrook, R., and Lo, B., 1990, Informing physicians about promising new treatments for severe illnesses, JAMA 263:2078–2082.

    Article  PubMed  CAS  Google Scholar 

  • Sugarman, S. D., 1990, The need to reform personal injury law leaving scientific disputes to scientists, Science 248:823–827.

    PubMed  CAS  Google Scholar 

  • Sussman, J. H., 1991, Financial considerations in technology assessment, Top. Health Care Financ. 17:30–41.

    PubMed  CAS  Google Scholar 

  • Thompson, W. D., 1987, Statistical criteria in the interpretation of epidemiologic data, Am. J. Publ. Health 77:191–194.

    CAS  Google Scholar 

  • Turner, D. A., Alcorn, F, Shorey, W. D., Stelling, C. B., Mategrano, V., Merten, C. W., Silver, B., Economou, S. G., Straus, A. K., Witt, T. R., and Norusis, M., 1988, Carcinoma of the breast: Detection with MR Imaging versus xeromammography, Radiology 168:49–59.

    PubMed  CAS  Google Scholar 

  • Udvarhelyi, I. S., Colditz, G. A., Rai, A., and Epstein, A. M., 1992, Cost-effectiveness and cost-benefit analyses in the medical literature: Are the methods being used correctly? Ann. Intern. Med. 116:238–244.

    PubMed  CAS  Google Scholar 

  • United States Pharmacopeial Convention, 1998, Drug Information for the Health Care Professional, Author, Rockville, MD.

    Google Scholar 

  • US Department of Health and Human Services, PHS, Agency for Health Care Policy Research, 1990, AHCPR Program Note, US Department of Health and Human Services, Rockville, MD.

    Google Scholar 

  • Veluchamy, S., and Saver, C. L., 1990, Clinical technology assessment, cost-effectiveness adoption, and quality management by hospitals in the 1990s, Qual. Rev. Bull. 16:223–228.

    CAS  Google Scholar 

  • Vermeulen, L. C., Matuszewski, K. A., Ratko, T. A., Burnett, D. A., and Vlasses, P. H., 1994, Evaluation of ondansetron prescribing in US academic medical centers, Arch. Intern. Med. 154:1733–1740.

    Article  PubMed  Google Scholar 

  • Vermeulen, L. C., Ratko, T. A., Erstad, B. L., Brecher, M. E., and Matuszewski, K. A., 1995, A paradigm for consensus: The University Hospital Consortium guidelines for the use of albumin, nonprotein colloid, and crystalloid solutions, Arch. Intern. Med. 155:373–379.

    Article  PubMed  Google Scholar 

  • Ware, J. E., and Sherbourne, C. D., 1992, The MOS 36-item short-form health survey (SF-36), Med. Care 30:473–483.

    PubMed  Google Scholar 

  • Wennberg, J. E., 1996, Dartmouth Atlas of Health Care, American Hospital Publishing, Chicago, IL.

    Google Scholar 

  • Yim, J. M., Matuszewski, K. A., Vermeulen, L. C., Ratko, T. A., Burnett, D. A., and Vlasses, P. H., 1995a, Surveillance of colony-stimulating factor use in U.S. academic health centers, Ann. Pharmacotherapy 29:475–481.

    CAS  Google Scholar 

  • Yim, J. M., Vermeulen, L. C., Erstad, B. L., Matuszewski, K. A., Burnett, D. A., and Vlasses, P. H., 1995b, Albumin and non-protein colloid solution use in U.S. academic health centers. Arch. Intern. Med. 155:2450–2455.

    Article  PubMed  CAS  Google Scholar 

  • Young, F. E., 1988, Paying for Progress: Reimbursement and Regulated Medical Products, presented to the Blue Cross and Blue Shield Technology Management Conference, Chicago, November.

    Google Scholar 

  • Yusef, S., Peto, R., Lewis, J., Collins, R., and Sleight, P., 1985, Beta blockage during and after myocardial infarction: An overview of the randomized trials, Prog. Cardiovasc. Dis. 27:335–371.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Knowledge Service, University HealthSystem Consortium, Clinical Practice Advancement Center, Oak Brook, Illinois, 60523

    Karl A. Matuszewski

  2. Department of Health Systems Management, Rush University, Chicago, Illinois, 60612

    Karl A. Matuszewski

Authors
  1. Karl A. Matuszewski
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Rush University, Chicago, Illinois

    Denise M. Oleske

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Kluwer Academic Publishers

About this chapter

Cite this chapter

Matuszewski, K.A. (2002). Technology Assessment. In: Oleske, D.M. (eds) Epidemiology and the Delivery of Health Care Services. Springer, Boston, MA. https://doi.org/10.1007/0-306-47557-X_10

Download citation

  • DOI: https://doi.org/10.1007/0-306-47557-X_10

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-306-46525-3

  • Online ISBN: 978-0-306-47557-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation