Technology assessment in medicine: methods, status and trends.

The contribution of medical technologies to the rising costs of health care is generating increasing enthusiasm for application of methods for assessing the impact of the technologies on health care cost and quality. Various assessment methods are available, ranging from rigorous Randomized Controlled Clinical Trials to informal Opinion Surveys of practitioners experienced with the technologies. Between these extremes are techniques such as Performance Analysis, Case Series, Case Studies, Metanalysis and Consensus Development. In the United States several institutions are involved in the technology assessment process. These institutions include government agencies, third-party carriers, advisory groups, and professional organizations. Currently these institutions emphasize variables such as safety, effectiveness and, less frequently, cost-effectiveness as criteria of technology assessment. However, outcome measures such as morbidity and mortality statistics and 'quality of life' parameters are receiving increased attention as more penetrating criteria for technology assessment.