Health-related quality of life and cost-effectiveness analysis in radiology.

The number of radiological studies performed annually, including ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), has been increasing dramatically. This trend is influenced by several factors, including an aging population with multiple comorbidities and a higher number of overall studies obtained per patient and/or per time period (1). More than ever before, radiology is playing an integral role during both initial investigations and follow-up of patients with acute and chronic illnesses. For example, Beinfeld and Gazelle (2) determined that medical technology has accounted for 19% of the growth in hospital costs between 1998 and 2000 and that imaging costs at one major tertiary care center increased by 50% between 1996 and 2002. In this challenging practice environment, evidencebased medicine has been recognized as an essential tool for deciding on appropriate diagnostic, medical, and interventional care for patients. Additionally, greater emphasis is being placed on cost-effectiveness analysis (CEA) and health-related quality of life (HRQOL) outcomes to guide utilization of high-tech, often high-cost, diagnostic and therapeutic radiological resources. Equally important (perhaps more so in certain situations), these often less tangible values are increasingly being measured in addition to the physical outcomes. Much of the early development of HRQOL assessments focused specifically on patients with cancer (3–5) and those with chronic renal failure on he-