Objectives: The purpose of this review was to examine whether studies from the medical literature focusing on efficiency of diagnostic facilities reported economic evaluation methods appropriately, following guidelines for conducting and reporting economic evaluations.Methods: A Medline search was conducted, and studies that concerned a diagnostic technology
and fulfilled the Drummond criteria were selected for methodological review. The reliability of selection
and methodological review based on the abstracts was determined by scoring a random sample of
both abstracts and full articles. lnterrater reliability was determined by scoring a random sample of
abstracts by both authors. Kappa values were calculated. Nine methodological aspects were reviewed:
study design, the type of economic evaluation, the comparison made, the study's perspective, the
cost-effectiveness ratio used, the definition of cost-effective, the types of costs analyzed, the cost
calculation method, and the use of sensitivity analysis.Results: Two hundred fifty studies published between 1992 and 1997 were found regarding efficiency
of diagnosticfacilities; 134 studiesfulfilled the Drummond criteriaand were selected for methodological
review. Kappavalues showed reliability of selection and methodological review and interrater reliability.
The existing literatue on the economic evaluation of diagnostic facilities does not adhere well to
guidelines for economic evaluation. In 95%, no perspective was mentioned, in 50% of the cases no
ratio was given, in 82% the cost calculation method was not mentioned, and in 66% no sensitivity
analysis was reported.Conclusions: Our review suggests that to improve the quality of reporting economic evaluations,
editorial boards could issue and enforce guidelines for standard reporting of such studies.