Associate Chair and Associate Professor, Department of Radiology, NYU Grossman School of Medicine, New York, New York; Chair, ACR Steering Committee on Incidental Findings; and Specialty Chair, Appropriateness Criteria Expert Panel on Gynecologic and Obstetrical Imaging.
Professor, Department of Population Health and Chief, Section on Value and Effectiveness Research, Department of Population Health, NYU Grossman School of Medicine, New York, New York.
J Am Coll Radiol. 2023 Mar;20(3):292-298. doi: 10.1016/j.jacr.2022.11.018.
Economic evaluation for implementation science merits unique considerations for a local context, including the main audience of local decision makers. This local context is in contrast with traditional methods for developing coverage policy for medical tests and interventions, which typically emphasize benefits and costs more broadly, for society. Regardless of the strength of evidence backing the efficacy or effectiveness of a clinical intervention, local context is paramount when implementing evidence-based practices. Understanding the costs throughout the processes of implementing a program will inform the decision of whether to plan for and adopt the program, how to sustain the program, and whether to scale up widely. To guide economic evaluation for implementation of evidence-based imaging practices, we describe approaches that consider local stakeholders' needs and connect these with outcomes of cost and clinical utility. Illustrative examples of implementation strategies and economic evaluation are explored in areas of cancer screening and care delivery.
经济评估对于实施科学而言，需要针对当地情况进行独特的考虑，包括当地决策者这一主要受众。与传统的医疗检测和干预措施覆盖政策制定方法相比，当地情况截然不同，后者通常更加强调更广泛的社会效益和成本。无论临床干预措施的疗效或有效性的证据有多充分，在实施基于证据的实践时，当地情况都是至关重要的。了解整个实施过程中的成本情况将有助于决策者做出是否计划和采用该方案、如何维持该方案以及是否广泛推广的决策。为了指导基于证据的影像学实践实施的经济评估，我们描述了一些方法，这些方法既考虑了当地利益相关者的需求，又将这些需求与成本和临床实用性的结果联系起来。在癌症筛查和护理提供领域中，探讨了实施策略和经济评估的示例。
