Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-22T18:17:35.040Z Has data issue: false hasContentIssue false

Technology Assessment—Impact on Medical Practice

Published online by Cambridge University Press:  10 March 2009

Felix Gutzwiller
Affiliation:
University of Lausanne
Richard Chrzanowski
Affiliation:
University of Lausanne

Extract

“Technology assessment” is still a relatively new concept, and its application to the field of medicine is even more recent. This results not only from an important effort to develop the scientific basis for health care, but also as a consequence of the growing concern about medical care costs (19). The term refers basically to the evaluation of the costs and effects of a medical technology. The most important methodological approach in this area has been, and still is, the traditional clinical trial, defined by Bradford Hill as “A carefully and ethically designed experiment with the aim of answering some precisely framed question,” including random allocation of the subjects in the trial (4).

Type
Technology Assessment: Policy, Clinical, and Methodological Issues
Copyright
Copyright © Cambridge University Press 1986

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Baum, M. L., Anish, D. S., Chalmers, T. C. et al. , A survey of clinical trials of antibiotic prophylaxis in colon surgery: Evidence against further use of no-treatment controls. New England Journal of Medicine, 1981, 305, 795799.CrossRefGoogle ScholarPubMed
2.Bell, R. S. & Loop, J. W.The utility and futility of radiographic skull examination for trauma. New England Journal of Medicine, 1971, 284, 236239.CrossRefGoogle ScholarPubMed
3.Boissel, J.-P.Impact of randomized controlled trials on the progress of therapy in cardiovascular diseases. Revue d' Epidémiologie et Santé Publique, 1984, 32, 212218.Google ScholarPubMed
4.Bulpitt, C. J.Randomised controlled clinical trials. The Hague, Boston, London: Martinus Nijhoff, 1983.CrossRefGoogle Scholar
5.Chalmers, T. C.The impact of controlled trials on the practice of medicine. Mount Sinai Journal of Medicine, 1974, 41, 753759.Google ScholarPubMed
6.Chalmers, T. C.Who will fund clinical trials? The Sciences, 03 1982, 68.CrossRefGoogle Scholar
7.Christensen, E., Juhl, E., & Tygstrup, N.Treatment of duodenal ulcer: Randomized clinical trials of a decade (1964–1974). Gastroenterology, 1977, 73, 11701178.CrossRefGoogle Scholar
8.Cocco, A. E., & Cocco, D.A survey of cimetidine prescribing. New England Journal of Medicine, 1981, 304, 1281.CrossRefGoogle ScholarPubMed
9.ECRI Technology Assessment. Deaths during general anesthesia. Journal of Health Care Technology, 1985, 1, 155175.Google Scholar
10.Fineberg, H. V., & Hiatt, H. H.Evaluation of medical practices: The case for technology assessment. New England Journal of Medicine, 1979, 301, 10861091.CrossRefGoogle ScholarPubMed
11.Finkelstein, S. N., Schectman, S. B., Sondik, E. J. et al. , Clinical trials and established medical practice: Two examples. In Roberts, E. B., Levy, R. I., Finkelstein, S. N. et al. (Eds.), Biomedical Innovation. Cambridge, Mass.: MIT Press, 1981, 201214.Google Scholar
12.Hoekelman, R. A.The impact of ambulatory pediatric research on changing behavior. American Journal of Diseases of Children, 1978, 132, 10791081.Google ScholarPubMed
13.Jacobs, E., Winter, P., Alvis, H. et al. , Hyperoxygenation effects on cognitive functioning in the aged. New England Journal of Medicine, 1969, 281, 753.CrossRefGoogle ScholarPubMed
14.Kirkmann-Liff, B., Dandoy, S., & Kallet, G.Cost of hepatitis B prevention in hospital employees. Journal of Health Care Technology, 1985, 1, 141154.Google Scholar
15.Miao, L. Gastric freezing: An example of the evaluation of medical therapy by randomized clinical trials. In Bunker, J. P., Barnes, B. A. & Mosteller, F. (Eds.), Costs, risks, and benefits of surgery. New York: Oxford University Press, 1977.Google Scholar
16.Nordic Council on Medicines. Nordic statistics on medicines, A10: Antidiabetics. Uppsala: NLN Publication No. 8, p. 87. (Communication E. Hemminki).Google Scholar
17.Potchen, E. J. The value of efficacy studies. In Roberts, E. B., Levy, R. I., Finkelstein, S. N. et al. (Eds.), Biomedical Innovation. Cambridge, Mass.: MIT Press, 1981, 275283.Google Scholar
18.Reuler, J. B., & Campbel, J. A.Cost analysis of a needle stick protocol. Medical Decision Making, 1982, 2, 130137.CrossRefGoogle ScholarPubMed
19.Russel, L. B. The role of technology assessment in cost control. In McNeil, B. J. & Carvalho, E. J. (eds.), Critical Issues in Medical Technology. Boston, Mass.: Auburn House, 1982, 129138.Google Scholar
20.Szmuness, W., Stevens, C. E., Harvey, E. J. et al. , Hepatitis B vaccine. Demon stration of efficacy in a high risk population in the United States. New England Journal of Medicine, 1980, 303, 833841.CrossRefGoogle Scholar
21. University Group Diabetes Program (UGDP) A study of the effects of hypoglycemic agents on vascular complications in patients with adult onset diabetes. Diabetes, 1970, 19, 747.Google Scholar
22.U.S. Congress, Office of Technology Assessment. The impact of randomized clinicaltrials on health policy and medical practice. Washington, D.C., 1983, OTA-BP-H-22.Google Scholar
23.World Health Organization. A rational approach to radiodiagnostic investigations. Geneva: WHO Technical Report Series, No. 689, 1983.Google Scholar