Hollingworth William, Jarvik Jeffrey G
Department of Radiology, University of Washington, Box 359960, 325 Ninth Ave, Seattle, WA 98104-2499, USA.
Radiology. 2007 Jul;244(1):31-8. doi: 10.1148/radiol.2441051790. Epub 2007 May 23.
In this review, which is part of a larger series on evidence-based practice in radiology, the relationship between technology assessment (TA) and the practice of evidence-based radiology (EBR) is discussed. TA guides researchers in the methods required to be reliable providers of unbiased and relevant evidence. Meanwhile, EBR equips radiologists with the skills needed to be discerning consumers of that evidence. Both paradigms aim to improve the effectiveness of health care spending. In this review, it is argued that EBR can be only as good as the TA on which it is based. However, TA is particularly complex in regard to diagnostic radiology because of the many links in the chain between the interim objective (to make the correct diagnosis) and the ultimate goal (to improve patient health). In this article, the development of TA in medicine in general and, more specifically, the TA hierarchy for the evaluation of diagnostic imaging are described. Some of the improvements in the pool of evidence during the past 30 years are documented, and some of the remaining tensions between TA and EBR are highlighted.
本综述是关于放射学循证实践的一系列文章的一部分，探讨了技术评估（TA）与循证放射学（EBR）实践之间的关系。TA指导研究人员掌握成为无偏见且相关证据可靠提供者所需的方法。同时，EBR使放射科医生具备辨别该证据的技能。这两种范式都旨在提高医疗保健支出的有效性。在本综述中，有人认为EBR的质量取决于其所基于的TA。然而，由于在中间目标（做出正确诊断）和最终目标（改善患者健康）之间的链条中有许多环节，TA在诊断放射学方面尤其复杂。本文描述了医学领域TA的总体发展情况，更具体地说，描述了用于评估诊断成像的TA层次结构。记录了过去30年证据库中的一些改进，并强调了TA与EBR之间仍然存在的一些矛盾。
