Standardized Expert Evaluation: An Approach to Study New Medical Technology


This is a case study on how to conduct a standardized expert evaluation of a new medical technology used in a subdiscipline of medicine, namely urology. Endourology is the subspecialty of urology that involves endoscopic procedures to deal with various urologic pathologies including renal stones. Several new tools have been introduced in this field to improve surgical performance. One such technological advancement is the introduction of new fully digital ureteroscopes. The objective is to provide better visibility than conventional analogue scopes and thereby improve the operative efficacy of endoscopic procedures. The new digital ureteroscopes work with a fixed high-definition stack system (that includes an integrated camera amplifier, a light source, and the digital ureteroscope mounted together in a single unit) which holds the promise of offering better image quality than the analogue systems. However, the digital stack system is a huge capital investment. An alternative could be to use a portable light source and camera system with these new digital ureteroscopes. Is it really worthwhile to upgrade to the new expensive completely digital ureteroscope with stack system? Or can a portable system do the job as well? Blinded independent assessment of the image quality obtained from the two systems would be an appropriate method to resolve this dilemma. This case study details a research design involving standardized expert evaluation to compare the image quality of the two imaging systems and thereby identify whether a portable and less costly option can be a viable clinical alternative without compromising imaging quality.

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