[Selection of clinical evaluation criterion and method of measurement]

The criterion for clinical evaluation of radiotherapy is defined by the authors as follows: Cost-effectiveness = Quality adjusted life year of a patient divided by the expenditure for the patient. Here, quality adjusted life year is calculated by estimating transition probabilities employing the Malkov process model. An expression model for estimation of radiotherapy effectiveness of the patient was proposed and applied. The actual cost of radiotherapy for the patient was calculated by carrying out a Care Map Study in a radiotherapy facility. The time study measures, the hours spent treating the patient by the kind of medical staff. Then, cost-effectiveness was calculated using these two variables in 2,926 patients from 147 radiotherapy facilities collected from a multi-institutional radiation oncology database developed and operated for the five years. A worksheet composed of 55 items of radiotherapy record for one site of a patient. Another worksheet for patient follow-up was composed of 14 items. Six retrospective and prospective data collections and three follow-up investigations were carried out. This study intended to determine the cost-effectiveness of radiotherapy in terms of cancer sites, diseases and treatment modalities. A further target is to expand this method to evaluate new technologies of health care at large as well as radiation oncology.