Critical Questions Regarding a New Diagnostic Technology: A Case Study Using Computerized Tomography of the Head

  • B. J. McNeil
  • J. A. Hanley
Conference paper


Controversy among neurologists, radiologists, public health planners, hospital administrators, and politicians has marked the use of computerized tomography (CT) since its inception in 1973. At one extreme, some have pointed to its high costs and unproven efficacy and say we should be concerned about its rapid diffusion and potential overuse (Office of Technology Assessment 1978 b). At the other extreme are those who have pointed to its safety, its freedom from discomfort for the patient, and its unique ability to image soft tissues as reasons for encouraging its rapid diffusion and availability to larger segments of the population (Baker 1975). Both extremes have highlighted three key questions that must be asked of any new technology;
  1. (1)

    Is it more efficacious than existing alternatives? (In this case the existing alternative is radionuclide imaging). How much so?

  2. (2)

    Can we direct it towards those who need it the most? (Or, keep it away from those who need it least?) What tradeoffs would be involved if we were to try to be more selective in its use?

  3. (3)

    How much does it cost?

This paper will address briefly the first two questions using data from several studies conducted in the United States.


Computerize Tomography Receiver Operating Characteristic Curve Computerize Tomography Examination Cerebellar Ataxia Diagnostic Technology 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 1983

Authors and Affiliations

  • B. J. McNeil
    • 1
  • J. A. Hanley
    • 1
  1. 1.Harvard and McGillUSA

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