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At least 541 records · Page 30Linked to original sources
PubMed2004

Cassetteless digital x-ray systems.

Cassetteless digital x-ray (DX) systems combine film-quality images and fast patient throughput. Because they are expensive, they need to be versatile enough to perform most or all radiographic projections. To meet this challenge, DX manufacturers have developed a variety of imaging detectors and gantry configurations. This presents facilities with an array of choices. In this Evaluation, we examine cassetteless DX systems from six suppliers: Canon, Fujifilm, Imaging Dynamics, Kodak, Siemens, and Swissray. We compare them with the three systems--from Del Medical, GE, and Philips--that we evaluated in our November 2001 issue. Our testing examines the ability of these systems to provide at least the same amount of diagnostic information as conventional screen-film systems while significantly increasing the overall efficiency of the radiology department. Each system provides a slightly different trade-off between image quality and usability. We rate three systems Preferred due to their excellent image quality, good ease of use, and the wide range of exams they can provide using a single detector. The remaining six devices are all rated Acceptable, although one of them is ranked slightly superior to the other five.

Equipment Design↗
PubMed2004

[A review of health economic assessment for liver transplantation--toward social acceptance of liver transplantation in Japan].

This paper reviews the literature on health economics assessment (HEA) for liver transplantation (LT) in Europe and USA, and considers prospects in Japan where HEA is currently rarely performed. LT is one of the most expensive health technologies but the health outcome is generally good. It provides the only well-established treatment for end-stage liver disease (ESLD) in the Western world, while in Japan it has yet to be fully implemented because public acceptance is still very low. MEDLINE and Japana Centra Revuo Medicina WEB version Ver. 2 (JCRM2) were systematically used for the literature search. As a result, 6 original papers in Europe and USA that employed accurate methods for HEA were identified through MEDLINE, indicating that LT is cost-effective on long term follow-up. In Japan, however, only one study could be good which tried to estimate it's cost-effectiveness, and the methodology was different from that used in Europe and USA. Through accurate HEA for LT in Japan, we hope that this procedure may become a well-accepted health technology in the future.

Cost-Benefit Analysis↗
PubMed2004

Health care technology assessment. Basic principles and clinical applications.

Health care technology (defined as all drugs, devices, and medical and surgical procedures used in medical care as well as the organizational and supportive systems within which such care is provided) is widely regarded as an important driver of escalating health care spending in the United States. Many new health care technologies are adopted and used in clinical practice with little or no evidence that their use is associated with improved patient outcomes. Orthopaedic surgeons are facing increasing scrutiny from hospitals and payers regarding the adoption and use of new technology for the treatment of patients with musculoskeletal disease. Health care technology assessment is a growing field that is concerned with the multidisciplinary evaluation of clinical data on the basis of safety and efficacy as well as economic aspects of technology acquisition. Through an understanding of the relevant literature and the concepts of health care technology assessment, orthopaedic surgeons have an opportunity to participate in the assessment process and thus influence clinical and health policy decisions regarding the adoption and use of new and existing technologies in the field of orthopaedic surgery.

Delivery of Health Care↗
PubMed2004

Wireless body area networks for healthcare: the MobiHealth project.

The forthcoming wide availability of high bandwidth public wireless networks will give rise to new mobile health care services. Towards this direction the MobiHealth project has developed and trialed a highly customisable vital signals' monitoring system based on a Body Area Network (BAN) and an m-health service platform utilizing next generation public wireless networks. The developed system allows the incorporation of diverse medical sensors via wireless connections, and the live transmission of the measured vital signals over public wireless networks to healthcare providers. Nine trials with different health care cases and patient groups in four different European countries have been conducted to test and verify the system, the service and the network infrastructure for its suitability and the restrictions it imposes to mobile health care applications.

Biomedical Technology↗
PubMed2006

Magnetic resonance imaging systems: evaluation of 1.5-Tesla systems.

Magnetic resonance imaging (MRI) systems manipulate magnetic fields and radio-frequency signals to create diagnostic images of human anatomy. An MR system is an essential clinical tool, but the cost of buying and installing one is high, so it's crucial that hospitals choose a model carefully. The selection process is made more complex by the numerous options available: different field strengths, gradient systems, coils, and channels, to name just a few. Also, some systems are better than others at facilitating specialized imaging, such as breast and cardiac studies. Our Evaluation is intended to help clarify the choices. We tested three 1.5-tesla systems from three suppliers--GE, Siemens, and Toshiba. We rate the systems for two different uses: inpatient imaging (performed in hospitals) and outpatient imaging (most often performed in imaging centers). For inpatient facilities, which are likely to have less responsive patients and to treat more complex medical problems, the most important purchase considerations will be patient positioning features, advanced imaging capabilities, and system integration. For outpatient facilities, the ability to perform routine exams efficiently and comfortably will be most important. We also provide separate ratings for each system's ability to meet the needs of three specialized applications--breast imaging, cardiac imaging, and functional MRI.

Biomedical Technology↗
PubMedDate not supplied

Medical high-technology assessment and implementation in a community hospital: nuclear magnetic resonance.

Health care administrators and physicians are under intense pressure from the government, industry, and the public at large to contain the escalating cost of health care. Operating margins of hospitals are averaging about 1%, and some hospitals are closing their doors. Health care providers are thus faced with the dilemma of how to bring costly high technology to a community hospital in a timely and effective manner without incurring serious financial setbacks. Despite all these pressures, we have presented several reasons why a community hospital should bring costly technology to its medical staff, and thus to its patients. We have described Kettering Medical Center's approach to this problem and our success in bringing it to the community early and cost-effectively, which has benefited the local community as well as the medical center. Our desire to be one of the "early adopters" may not work for everyone, since it requires extremely careful and perceptive evaluation of the technologic developments. It requires an intelligent, progressive, and committed board, administration, and medical staff, and it requires clever financing, such as large outside grants and help from a medical school. Such partnerships and research organizations, or liaisons with government agencies such as the Veterans Affairs system, are believed to be the keys in getting costly high technology into a community hospital. To achieve this, administration and key medical staff should constantly be on the lookout, evaluating high-technology developments. Once the hospital decides to get into a costly new high technology, it must seek alliances or partnerships with others. To identify, assess, and acquire new technology is an ongoing process.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost Control↗
PubMed1991

[Radiology in Scandinavia].

In 1987 the Nordic Institutes of Hospital Research joint co-operation on medical technology assessment (NEMT) performed a study of the national differences in the utilization of diagnostic techniques in the radiological laboratories. Major differences between the countries were found in both total and specific examination rates. In total numbers of conventional investigations, Finland performed about 60 per cent more investigations than the average of Sweden, Denmark and Norway, which all were of the same level of approximately 470 examinations per 1,000 inhabitants. The difference was attributed mainly to X-ray investigations executed at the primary health care level in Finland. Other remarkable differences were in particular observed in techniques of increasing or decreasing importance.

Angiography↗
PubMed1988

The introduction of low-osmolar contrast agents in radiology. Medical, economic, legal, and public policy issues.

This case study of the public policy implications of introducing a new technology in radiology, namely, low-osmolar contrast media (LOCM), raises the issues of whether and how to place appropriate limits on new technologies. Although these contrast media represent small episodic costs, they may add up to an aggregate expenditure of nearly $1 billion per year if used for all contrast injections. As a result, this technology raises a number of important medical, economic, legal, and public policy questions. Our cost-effectiveness analysis and an analysis of the medical evidence suggest that LOCM should be limited to high-risk patients. We discuss in this article how the legal system might respond to such limitations, and we consider various public policy options for adopting restrictions on use. We conclude that the medical profession should take the lead in developing protocols for appropriate assessment, reimbursement, and use of LOCM.

Contrast Media↗
PubMedDate not supplied

Assessment and approval of medical devices used in diagnostic imaging in the United States.

Development of new and improved medical imaging technology has been increasing rapidly over the past two decades. While media attention has focused on the revolutionary advances, such as computed tomography, magnetic resonance imaging and metabolic assessment by positron emission tomography, important progress has also been made in the more conventional modalities, including contrast radiography, ultrasound, scintigraphy and mammography. These evolutionary developments have produced fundamental changes in the character of imaging information and in the methods of its acquisition, storage, manipulation, analysis and display. The assessment process-vis-à-vis safety, effectiveness, efficacy or cost-has moved from a previously well-defined physical and engineering evaluation to one of assessing quality, relevance and appropriateness of the "information." A regulatory scheme has evolved in the U.S., whereby the Food and Drug Administration (FDA) is responsible for assuring that new medical devices be approved for commercial distribution only if their safety and effectiveness can be assured. Clear distinctions should be drawn between the FDA "approval" process, assessment of clinical efficacy, and planning for health care delivery.

Certificate of Need↗