Understanding the medical and nonmedical value of diagnostic testing

Value Health. Mar-Apr 2010;13(2):310-4. doi: 10.1111/j.1524-4733.2009.00597.x. Epub 2009 Sep 10.

Abstract

Objectives: To develop a framework for defining the potential value of diagnostic testing, and discuss its implications for the health-care delivery system.

Methods: We reviewed the conceptual and empirical literature related to the valuing of diagnostic tests, and used this information to create a framework for characterizing their value. We then made inferences about the impact of this framework on health insurance coverage, health technology assessment, physician-patient relationships, and public health policy.

Results: Three dimensions can effectively classify the potential value created by diagnostic tests: 1) medical value (impact on treatment decisions); 2) planning value (affect on patients' ability to make better life decisions); and 3) psychic value (how test information affects patients' sense of self). This comprehensive framework for valuing diagnostics suggests that existing health technology assessments may systematically under- or overvalue diagnostics, leading to potentially incorrect conclusions about cost-effectiveness. Further, failure to account for all value dimensions may lead to distorted payments under a value-based health-care system.

Conclusions: The potential value created by medical diagnostics incorporates medical value as well as value associated with well-being and planning. Consideration of all three dimensions has important implications for technology assessment and value-based payment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cost-Benefit Analysis
  • Decision Making
  • Diagnostic Techniques and Procedures / economics*
  • Diagnostic Techniques and Procedures / psychology*
  • Humans
  • Insurance Coverage
  • Insurance, Health
  • Patient Satisfaction
  • Physician-Patient Relations
  • Quality of Health Care*
  • Technology Assessment, Biomedical*