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Cost-Effectiveness Analysis in Radiology: A Systematic Review.

Alice Zhou1, David M Yousem2, Matthew D Alvin2

  • 1Johns Hopkins School of Medicine, Baltimore, Maryland.

Journal of the American College of Radiology : JACR
|July 31, 2018
PubMed
Summary

Cost-effectiveness analyses (CEAs) in radiology lack standardized methods, leading to varied conclusions. This review highlights variations in perspective, cost inclusion, and willingness-to-pay thresholds, urging for improved standardization in radiology CEA.

Keywords:
Cost effectivenessQALYcost utilityoutcomesquality of life

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Area of Science:

  • Health economics
  • Radiology

Background:

  • Cost-effectiveness analyses (CEAs) are increasingly used in radiology.
  • Lack of standardized methodology in CEAs leads to conflicting conclusions and hinders policy recommendations.

Purpose of the Study:

  • Review recent CEAs in radiology to identify methodological variations.
  • Explore the impact of these variations on interpretation.
  • Discuss optimal strategies for performing CEAs in radiology.

Main Methods:

  • Systematic review of cost-utility analyses in radiology from 2013-2017.
  • Analysis and comparison of cost and quality-of-life methods using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.

Main Results:

  • Eighty cost-utility studies were included. Significant variation was found in study perspective, cost inclusion (e.g., adverse effects, hospitalization), and utility measurement.
  • Most studies (80%) cited existing literature for utilities, and 90% used willingness-to-pay thresholds.

Conclusions:

  • Statistically significant methodological variations necessitate standardized approaches for performing and presenting CEAs in radiology.
  • Recommendations are provided for study perspective, cost inclusion, and willingness-to-pay thresholds.
  • Further work is needed to ensure comparability and transparency for informed policymaking.