Steinberg diagnostic medical imaging12/16/2023 During this same interval, there has been an increase in health care expenditures attributable to heart disease, with an estimated cost of $316 billion dollars in 2010 secondary to health care expenditures and lost productivity. Since 1968, there has been a steady decline in deaths from coronary heart disease in the United States. The current climate: why CEA is necessaryĬardiovascular disease remains the leading cause of death worldwide. In this review, we discuss the framework of cost-effectiveness analysis (CEA) and its application in cardiac imaging, specifically focusing on cardiovascular magnetic resonance (CMR). In this setting, cardiac imaging has come under increased scrutiny, owing to increased use and unclear benefit. The limit of health care resources is even more pronounced in the current economic climate, forcing a balance between fiscal restraint and optimal use of resources to maximize health. Over the ensuing decades, the health care environment (and available technologies) has continued to evolve. In a seminal paper in 1977, Weinstein and Stason introduced the concept of cost-effectiveness in health care to a broad clinical audience. This fact was not, perhaps, perceived to be so a few decades ago, before health insurance became so pervasive and before medical technologies had proliferated to the extent that they have today”. “It is now almost universally believed that the resources available to meet the demands for health care are limited. The limitations of CEA across different study designs and geographic regions are discussed, and we also examine the strengths and weakness of the existing publications where CMR was the focus of CEA compared to other diagnostic options. We review the concepts and theories of cost-effectiveness analyses (CEA) as they apply to diagnostic tests in general. The benefits from a specific diagnostic technology depend therefore not only on its performance characteristics, but also on other factors such as prevalence of disease, and effectiveness of existing treatments for the disease of interest. Instead, the results of diagnostic tests can influence management decisions for patients and by this route, diagnostic tests indirectly affect long-term outcomes. New diagnostic tests differ from therapeutic procedures due to the fact that diagnostic tests do not generally directly affect long-term patient outcomes. Several challenges exist for a new diagnostic test to demonstrate cost-effectiveness. With the need for healthcare cost-containment, increased scrutiny will be placed on new medical therapeutic or diagnostic technologies.
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