Obtaining comparative effectiveness data to populate a CEA/CUA The use of MRI in Crohn’s disease is relatively new and there is likely to be limited evidence relating to its comparative effectiveness particularly in relation to the evaluation of response. While accuracy information may be available, data on change of management and impact on health outcomes may be limited. Sub group analysis of use of MRI in the evaluation of known or suspected Crohn’s disease in pregnancy. The lower radiation dose of MRI relative to CT, and hence its superior safety, is the key clinical claim of MRI in this population. The proposed population is also likely to be very small and it is possible that a discussion of the costs and consequences of funding MRI in this group may be more appropriate than a decision analytic model aimed at estimating cost effectiveness. Outcomes and health care resources affected by introduction of proposed intervention Outcomes MRI for patients with bowel Crohn’s disease Diagnostic performance Sensitivity Specificity Additional TP and FP Diagnostic yield Therapeutic impact % change in management plans (e.g. avoidance of surgical procedures) Patient outcomes Impact of treatment on symptoms Activity of disease Development of complications Crohn’s disease progression Treatment morbidity Quality of life MRI for patients with fistulising perianal Crohn’s disease Diagnostic performance Sensitivity Specificity Additional TP and FP Diagnostic yield Therapeutic impact
Obtaining comparative effectiveness data to populate a CEA/CUA The use of MRI in Crohn’s disease is relatively new and there is likely to be limited evidence relating to its comparative effectiveness particularly in relation to the evaluation of response. While accuracy information may be available, data on change of management and impact on health outcomes may be limited. Sub group analysis of use of MRI in the evaluation of known or suspected Crohn’s disease in pregnancy. The lower radiation dose of MRI relative to CT, and hence its superior safety, is the key clinical claim of MRI in this population. The proposed population is also likely to be very small and it is possible that a discussion of the costs and consequences of funding MRI in this group may be more appropriate than a decision analytic model aimed at estimating cost effectiveness. Outcomes and health care resources affected by introduction of proposed intervention Outcomes MRI for patients with bowel Crohn’s disease Diagnostic performance Sensitivity Specificity Additional TP and FP Diagnostic yield Therapeutic impact % change in management plans (e.g. avoidance of surgical procedures) Patient outcomes Impact of treatment on symptoms Activity of disease Development of complications Crohn’s disease progression Treatment morbidity Quality of life MRI for patients with fistulising perianal Crohn’s disease Diagnostic performance Sensitivity Specificity Additional TP and FP Diagnostic yield Therapeutic impact
1190-MRICrohns-FinalDAP-accessible.docx