Lin Alexander P, Tran Thao T, Ross Brian D
Rudi Schulte Research Institute, Santa Barbara, CA 93130, USA.
NMR Biomed. 2006 Jun;19(4):476-83. doi: 10.1002/nbm.1058.
Magnetic resonance spectroscopy (MRS) is a robust, non-invasive means of defining aspects of human neurochemistry. After more than two decades, it is clear that in addition to its scientific interest, MRS has diagnostic value in tumor diagnosis, prognosis, therapeutic outcome, dementia diagnosis and prognosis, multiple sclerosis, infections, trauma, development, stroke, perinatal ischemia, xenobiotics and inborn errors (as determined from a meta-analysis included in this paper). However, in many healthcare systems, a new radiological technique requires evidence-based medicine (EBM) before it is recommended for reimbursement. Much of the reason why MRS is thought to be non-reimbursable in the USA is due to recent announcements that this 15-year-old technique is still considered 'investigational' by these EBM assessments. An analysis is presented of the technology assessments that brought about this situation. Based on the conclusions of the EBM assessments, strategies are suggested that involve all entities responsible for spectroscopy including the scientists' role in ensuring the future for clinical spectroscopy.
磁共振波谱（MRS）是一种可靠的、非侵入性的界定人类神经化学特征的方法。二十多年过去了，很明显，除了具有科学价值外，MRS在肿瘤诊断、预后、治疗效果、痴呆症诊断与预后、多发性硬化症、感染、创伤、发育、中风、围产期缺血、外源性物质及先天性疾病（根据本文纳入的一项荟萃分析确定）方面具有诊断价值。然而，在许多医疗体系中，一种新的放射技术在被推荐用于报销之前需要循证医学（EBM）依据。在美国，MRS被认为不可报销的主要原因是最近宣布这项已有15年历史的技术在这些EBM评估中仍被视为“研究性的”。本文对导致这种情况的技术评估进行了分析。基于EBM评估的结论，提出了一些策略，这些策略涉及负责波谱分析的所有实体，包括科学家在确保临床波谱分析未来发展方面的作用。
