Exclusion and diagnosis of deep vein thrombosis by a rapid ELISA D- dimer test, compression ultrasonography, and a simple clinical model

The classical clinical signs of deep vein thrombosis (DVT) are unspecific and may be found in several other conditions besides DVT. Therefore, patients suspicious of DVT are subjected to elaborate invasive or noninvasive evidence-based procedures that actually confirm DVT in only 20% to 30% of patients in this setting. However, simple laboratory...

Use of societal criteria in evaluation of medical technology assessment research proposals in the Netherlands: Development and testing of a checklist

Rising health care costs, and the recognition that medical technology is a significant contributor to these costs, have provided the stimulus to develop medical technology assessment programmes in the Netherlands. The most important programme in this field is the Investigational Medicine Programme of the Dutch Sick Funds Council. So far,...

Lessons from the eight countries

While the eight countries presented in this issue differ considerably from each other, they have important similarities. All have faced the problem of increasing health care expenditures, and all are coming to recognize problems with health care technology such as inappropriate use and poor quality of care. Health reforms appear to be...

Health care technology as a policy issue

Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions concerning technology, including benefits and costs. A...