Original Title: Utilización de contrastes yodados en radiodiagnóstico

Authors' objectives: The aim is to assess whether or not the increase in health costs with the use of low osmolality contrast media is justified by a lower incidence of adverse reactions and the assumed reduction in costs derived from their treatment.

Authors' results and conclusions: The survey was sent to radiodiagnosis services and answered by 29 centers (53% of the total), 17 of which belonged to the public network, the other 12 being private. It was observed that high osmolality contrast media was used in 10.5% of all cases as compared to 88.8% low osmolality contrast media. The great variability in the use of these radiological contrast agents was notable between public and private hospitals, 93% of private hospitals using high-osmolality contrast media for computed tomography (CT) compared to 10% of public hospitals. The cost-effectiveness analysis concluded that the additional cost per avoided adverse reaction (moderate or severe) using the universal instead of the selective strategy amounted to 972,000 pesestas ($7,839). Through the cost-minimisation analysis, it was estimated that by using the selective strategy instead of the universal strategy the health system could make a potential saving of 170 million pesetas ($1,370,968) per year.

Authors' recommendations: According to scientific documentation on the subject and the recommendations made by other assessment agencies, and with an aim to optimising existing resources, it is concluded that a selective use of iodinated contrast media is sensible. This strategy means the use of high osmolality contrast media on low risk patients and the use of low osmolality contrast media on high risk patients. Scientific evidence indicates that maximum benefit is obtained from low osmolality contrast media, above all, when used with the high risk population. The legal report concludes that following recommendations, based on scientific evidence, can be classified as good professional practice; action taken based on these recommendations is a "non codified lex artis". For this reason, following the recommendations developed by the administration on this subject lessens professional liability.

Authors' methods: Bibliographic search of the Medline database for existing literature on the subject from April 1992 to October 1994. Thorough analysis and synthesis of selected bibliography, as well as publications by other health assessment agencies. Survey designed to establish consumption and variability in the use of different iodinated contrast media in clinical practice and presented to hospitals in the Basque health services network. Preparation of a decision making tree in order to carry out a cost-effectiveness analysis on the use of contrast media, using the computer programme Decision Maker 6.0. Three analysis on sensitivity and one on the minimization of costs, as a supplement to the cost-effectiveness analysis. Proposal of recommendations on the use of radiological contrast agents based on the classification of the population as high or low risk. a legal report on the legal liability of health staff in the case of a selective use of iodinated contrast media based on the recommendations proposed.

Project Status: Completed

Year Published: 1995

URL for published report: https://www.euskadi.eus/contenidos/informacion/1995_osteba_publicacion/es_def/adjuntos/1995/d_95_03_contrastes_yodados.pdf

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Osteba (Basque Office for Health Technology Assessment) Department of Health of the Basque Government</p>