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Proceedings Paper

Use Of Clinical Decision Analysis In Predicting The Efficacy Of Newer Radiological Imaging Modalities: Radioscintigraphy Versus Single Photon Transverse Section Emission Computed Tomography
Author(s): John R. Prince
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Paper Abstract

Sensitivity, specificity, and predictive accuracy have been shown to be useful measures of the clinical efficacy of diagnostic tests and can be used to predict the potential improvement in diagnostic certitude resulting from the introduction of a competing technology. This communication demonstrates how the informal use of clinical decision analysis may guide health planners in the allocation of resources, purchasing decisions, and implementation of high technology. For didactic purposes the focus is on a comparison between conventional planar radioscintigraphy (RS) and single photon transverse section emission conputed tomography (SPECT). For example, positive predictive accuracy (PPA) for brain RS in a specialist hospital with a 50% disease prevalance is about 95%. SPECT should increase this predicted accuracy to 96%. In a primary care hospital with only a 15% disease prevalance the PPA is only 77% and SPECT may increase this accuracy to about 79%. Similar calculations based on published data show that marginal improvements are expected with SPECT in the liver. It is concluded that: a) The decision to purchase a high technology imaging modality such as SPECT for clinical purposes should be analyzed on an individual organ system and institutional basis. High technology may be justified in specialist hospitals but not necessarily in primary care hospitals. This is more dependent on disease prevalance than procedure volume; b) It is questionable whether SPECT imaging will be competitive with standard RS procedures. Research should concentrate on the development of different medical applications.

Paper Details

Date Published: 29 December 1982
PDF: 8 pages
Proc. SPIE 0347, Application of Optical Instrumentation in Medicine X, (29 December 1982); doi: 10.1117/12.933827
Show Author Affiliations
John R. Prince, Research Medical Center (United States)

Published in SPIE Proceedings Vol. 0347:
Application of Optical Instrumentation in Medicine X
Gary D. Fullerton; James A. Mulvaney; Arthur G. Haus; William S. Properzio, Editor(s)

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