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The Journal of Nuclear Medicine Vol. 40 No. 9 1570-1581
© 1999 by Society of Nuclear Medicine
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Decision Analysis in Nuclear Medicine

Sanjiv Sam Gambhir

The Crump Institute for Biological Imaging and Department of Molecular and Medical Pharmacology, The Division of Nuclear Medicine and Department of Biomathematics, UCLA School of Medicine, Los Angeles, California

Correspondence: For correspondence or reprints contact: Sanjiv Sam Gambhir, MD, PhD, Crump Institute for Biological Imaging, UCLA School of Medicine, A-222B CIBI, 700 Westwood Plaza, Box 951770, Los Angeles, CA 90095-1770.

ABSTRACT

This review focuses primarily on the methodology involved in properly reviewing the literature for performing a meta-analysis and on methods for performing a formal decision analysis using decision trees. Issues related to performing a detailed meta-analysis with consideration of particular issues, including publication bias, verification bias and patient spectrum, are addressed. The importance of collecting conventional measures of test performance (e.g., sensitivity and specificity) and of changes in patient management to model the cost-effectiveness of a management algorithm is detailed. With greater utilization of the techniques discussed in this review, nuclear medicine researchers should be well prepared to compete for the limited resources available in the current health care environment. Furthermore, nuclear medicine physicians will be better prepared to best serve their patients by using only those studies with a proven role in improving patient management.

Key Words: decision modeling • meta-analysis • cost-effectiveness






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Copyright © 1999 by the Society of Nuclear Medicine.