Evaluation of the appropriateness of medical Technology

Publisher Summary

This chapter discusses the assessment and acquisition of new medical technology. New devices, diagnostic procedures, equipment, and systems of health-care delivery are continually being produced and flow rapidly into the nation's medical mainstream. This process has created additional burdens for the hospital administrators, clinical engineers, and medical staff who are responsible for the assessment and acquisition of new medical technology. As a result, there is a pressing need for clinical engineering departments to assume more responsibilities in these two areas. Any discussion regarding the management of medical technologies must include an evaluation of safety, efficacy, and cost-effectiveness as well as a consideration of the social, legal, and ethical effects of these devices. Unfortunately, these considerations have significantly lagged behind the procurement and use of new medical technologies in the clinical environment. For health-care institutions to remain cost-effective and competitive, it is absolutely essential that any new medical technology be chosen or selected based on the knowledge gathered about its performance, value, and availability. The chapter focuses on basic concepts associated with technology assessment, and also highlights the processes of innovation, development, and diffusion of medical technology in the modern health-care system. It also highlights various organizations and agencies, both public and private, that play important roles in technology assessment.

Copyright © 1992 Butterworth-Heinemann, a division of Reed Publishing (USA) Inc. Published by Elsevier Inc. All rights reserved.

Abstract

Medical Technology Assessment begins with carefully posing the appropriate questions to be examined. Specification of the critical assessment provides the framework for the design to provide the answers. This paper addresses the Technology Assessment process as a sequence of the above steps. The practical requisites of the diversity of questions, the economic, and study design considerations generated are addressed in a systems analysis model of input-process-outcome. Applications and the relative merits of such design consideration are discussed and illustrated. The questions related to medical technologies may come from different groups of people directly or indirectly interested, and having active or passive relationship to a given technology. There are 4 basic issues from which the detailed questions derive. These are the issues of need, effectiveness, safety and cost. The timing of asking questions in the life-cycle of a technology and the adequacy of the answers determines the choice of methods, the extent of an evaluation and the quality of the responses. The reliability, external validity, generalizability, and the clarity of conclusions are the characteristics of a practical and valuable assessment.

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Copyright © 1988 Published by Elsevier B.V.