IPEM Report No 82: Cost-Effective Methods of Patient Dose Reduction in Diagnostic Radiology

Institute of Physics and Engineering in Medicine York: IPEM (2001) 67 pp, 20.00 British Pounds, ISBN: 0-904181-98-7. The worldwide interest in patient dose reduction in radiology has been stimulated since the publication of a document on this subject by the Royal College of Radiologists (RCR) and the National Radiological Protection Board (NRPB) in 1990. Lots of recommendations have been proposed for reducing medical x-ray exposures but there is little information available on the cost per man Sv saved for various imaging modalities. However, in times of scarce resources for health care, it is important that the cost effectiveness of each dose reduction feature is assessed and proper priorities be determined. This report, consisting of six short chapters, was prepared by a joint working party of the Institute of Physics and Engineering in Medicine, the British Institute of Radiology and the National Radiological Protection Board. As the introductory chapter puts it, this report aims to provide a structured approach to the optimization of patient doses. It brings together information essential to carrying out a cost-effectiveness analysis on patient dose reduction features, including information on how to assess the actual dose reduction and real costs of a particular option, a review of data on the dose reduction possible and details on the decision-making techniques available. Three decision-aiding techniques, namely cost-effectiveness analysis, differential cost-benefit analysis and cost-benefit analysis, are discussed along with worked examples. A basic knowledge of economics is essential in order for one to fully appreciate and apply these techniques. The readers should also bear in mind that the examples used are based on the British health care system. The usefulness of this report lies with its scores of tables and figures providing information on cost and dose. Besides a few minor unclear and confusing figure captions, the overall quality of this report is high. Radiologists, medical physicists, radiation protection specialists and hospital administrators would find this report a useful reference in planning for new equipment in their departments. (book review)