Outcomes research and cost-effectiveness analysis in radiology.

The decision to implement a new medical technology requires that it not only increases survival or quality of life, but that it is also economically sound. The unique feature in the assessment of diagnostic tests is that the results of such tests are intermediate outcomes. Both randomized controlled clinical trials and decision analysis have an important role to play in the assessment of diagnostic tests. Important points to consider when performing a cost-effectiveness study are what perspective to take; comparing the technology with the next best strategy; including both effectiveness and costs; the distinction between describing and valuing the quality of life; intangibles such as the value of information; and the incremental cost-effectiveness ratio.