We raise a problem of applicability of RCTs to validate nuclear diagnostic imaging tests. In spite of the wide application of PET and other similar techniques that use radiopharmaceuticals for diagnostic purposes, RCT-based evidence on their validity is sparse. We claim that this is due to a general conceptual problem that we call Prevalence of Treatment, which arises in connection with designing RCTs for testing any diagnostic procedure in the present context of medical research, and is particularly apparent in this case. We also identify three practical reasons why RCTs do not qualify as the best option for PET validation, which have to do with specific characteristics of nuclear diagnostic imaging, and of radiopharmaceuticals. The paper is meant to contribute both to the philosophical discussion on the EBM hierarchy of evidence, and on the specific debate on radiopharmaceuticals in nuclear medicine.

Lalumera, E., Fanti, S. (2019). Randomized Controlled Trials for Diagnostic Imaging: Conceptual and Pratical Problems. TOPOI, 38(2), 395-400 [10.1007/s11245-017-9535-z].

Randomized Controlled Trials for Diagnostic Imaging: Conceptual and Pratical Problems

Lalumera, E.
Primo
;
2019

Abstract

We raise a problem of applicability of RCTs to validate nuclear diagnostic imaging tests. In spite of the wide application of PET and other similar techniques that use radiopharmaceuticals for diagnostic purposes, RCT-based evidence on their validity is sparse. We claim that this is due to a general conceptual problem that we call Prevalence of Treatment, which arises in connection with designing RCTs for testing any diagnostic procedure in the present context of medical research, and is particularly apparent in this case. We also identify three practical reasons why RCTs do not qualify as the best option for PET validation, which have to do with specific characteristics of nuclear diagnostic imaging, and of radiopharmaceuticals. The paper is meant to contribute both to the philosophical discussion on the EBM hierarchy of evidence, and on the specific debate on radiopharmaceuticals in nuclear medicine.
Articolo in rivista - Articolo scientifico
EBM RCT Diagnosis Nuclear medicine PET Diagnostic imaging Radiopharmaceuticals
English
dic-2017
2019
38
2
395
400
reserved
Lalumera, E., Fanti, S. (2019). Randomized Controlled Trials for Diagnostic Imaging: Conceptual and Pratical Problems. TOPOI, 38(2), 395-400 [10.1007/s11245-017-9535-z].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/177372
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