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MEDICAL TECHNOLOGY ASSESSMENT DIRECTORY A Pilot Reference to Organizations, Assessments, en c! Information Resources Clifforct Goodman, Eclitor COUNCIL ON HEALTH CARE TECHNOLOGY INSTITUTE OF MEDICINE NAnoNAL ACADEMY PRESS Washington, D.C. ~ 98~3

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NATIONAL ACADEMY PRESS 2101 Constitution Ave., NW Washington, DC 20418 NOTICE: This Directory, a project of the Council on Health Care Technology of the Institute of Medicine, fulfills in part the provision in Section 309 of Public Law 98-551 that the council serve as a clearinghouse for information on health care technologies and assessments. Activities of the council are supported by private sector contributions and grants (see Appendix B for a list of contributors) and federal matching grants provided by grant number HS 05526 from the National Center for Health Services Research and Health Care Technology Assessment. Program representatives who consider their program, or others, to be appropriate for future revisions of the Directory should contact the Council on Health Care Technology, Institute of Medicine, 2101 Constitution Ave., NW, Washington, DC 20418. Subscription to the council's quarterly newsletter, CHCTASSESSMENT, may be obtained for $20 per year from the same address. The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an advisor to the federal government and its own initiative in identifying issues of medical care, research, and education. Library of Congress Cataloging-in-Publication Data Medical technology assessment directory: a pilot reference to organizations, assessments, and information resources / Clifford Goodman, editor; Council on Health Care Technology, Institute of Medicine. p. cm. Prepared by the Council on Health Care Technology's Information Panel. Includes bibliographies and indexes. ISBN 0-309-03829-4 1. Medical technology-United States-Directories. 2. Medical technology-Directories. I. Goodman, Clifford. II. Council on Health Care Technology (Institute of Medicine). Information Panel. [DNLM: 1. Technology Assessment, Biomedical-United States- directories. W 22 AA1 M4916] R855.3.M43 1988 610'.28~c19 DNLM/DLC for Library of Congress Copyright ~ 1988 by the National Academy of Sciences 88-5358 CIP No part of this book may be reproduced by any mechanical, photographic, or electronic process or in the form of a phonographic recording, nor may it be stored in a retrieval system, transmitted, or otherwise copied for public or private use, without written permission from the publisher, except for the purposes of official use by the United States Government. Printed in the United States of America

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INFORMATION PANEL OF THE COUNCIL ON HEALTH CARE TECHNOLOGY LAWRENCE C. MORRIS Senior Vice President, Health Benefits Management, Blue Cross and Blue Shield Association, Chicago, Illinois (Chairman" GAIL L. WARDEN President and Chief Executive Officer, Group Health Cooperative of Puget Sound, Seattle, Washington (Co-Chairman) MORRIS F. COLLEN Consultant, Division of Research, Kaiser Permanente Medical Care Program, Oakland, California RICHARD C. FARMER Chairman, Division of Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio MELVIN A. GLASSER Director, Health Security Action Council, Washington, D.C. G. MAX K. HUGHES Vice President, Systems and Communication, Pfizer Pharmaceuticals, New York, New York RICHARD J. JOHNS Massey Professor and Director, Department of Biomedical Engineering, Johns Hopkins University and Hospital, Baltimore, Maryland DONALD A.B. LINDBERG Director, National Library of Medicine, National Institutes of Health, Bethesda, Maryland WALTER B. MAHER Director, Employee Benefits and Health Services, Chrysler Corporation, Detroit, Michigan ROSIN H. MOXLEY, III President, MetaMedical Inc., Beverly Hills, California C. THOMAS SMITH President, Yale-New Haven Hospital, New Haven, Connecticut GEORGE E.T. STEBBING Director, Professional Activities, Office of the Secretary of Defense, Health Affairs, Washington, D.C. Project Staff CLIFFORD S. GOODMAN, Staff Officer LESLIE M. HARDY, Research Associate PAMELA J. SIMERLY, Research Associate .- 111

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COUNCIL ON HEALTH CARE TECHNOLOGY WILLIAM N. HUBBARD, JR. former President, The Upjohn Company, Hickory Corners, Michigan (Chairman) JEREMIAH A. BARONDESS . Irene F. and I. Roy Psaty Distinguished Professor of Clinical Medicine, Cornell University Medical College, New York, New York (Co-Chairman) HERBERT L. ABRAMS Professor of Radiology, Stanford University School of Medicine, Stanford, California RICHARD E. BEHRMAN Dean, School of Medicine, Case Western Reserve University, Cleveland, Ohio PAUL A. EBERT Director, American College of Surgeons, Chicago, Illinois PAUL S. ENTMACHER Senior Vice President and Chief Medical Director, Metropolitan Life Insurance Company, New York, New York MELVIN A. GLASSER Director, Health Security Action Council, Washington, D.C. GERALD D. LAUBACH President, Pfizer Inc., New York, New York WALTER B. MAHER Director, Employee Benefits and Health Services, Chrysler Corporation, Detroit, Michigan ROBERT FI. McCAFFREY Chairman and Chief Executive Officer, C.R. Bard Inc., Murray Hill, New Jersey iv LAWRENCE C. MORRIS Senior Vice President, Health Benefits Management, Blue Cross and Blue Shield Association, Chicago, Illinois FREDERICK MOSTELLER Roger I. Lee Professor, Harvard School of Public Health, Boston, Massachusetts MARY O. MUNDINGER Dean, School of Nursing, Columbia University, New York, New York ANNE A. SCITOVSKY Chief, Health Economics Department, Palo Alto Medical Foundation, Palo Alto, California C. THOMAS SMITH President, Yale-New Haven Hospital, New Haven, Connecticut GAIL L. WARDEN President and Chief Executive Officer, Group Health Cooperative of Puget Sound, Seattle, Washington Stay ENRIQUETA C. BOND, Director, Division of Health Promotion and Disease Prevention RICHARD A. RETTIG, Director KATHLEEN N. LOHR, Senior Staff Officer ROBIN WEISS, Senior Staff Officer CLIFFORD S. GOODMAN, Staff Officer LESLIE M. HARDY, Research Associate PAMELA I. SIMERLY, Research Associate BOBBIE I. ALEXANDER, Assistant to the Director ANNETINE C. GELIJNS, International Fellow CHARLENE E. GREENE, Senior Secretary PATRICIA M. O'NEAL, Senior Secretary BRENDA E. PATTERSON, Senior Secretary

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ACKNOWLEDGMENTS A novel effort to assemble information from diverse sources, this Directory called for a blend of experience, original thinking, and resolve. We wish to acknowledge those who contributed these qualities to the project. O We are grateful to the members of the Information Panel for lending their experience in health plan and facility management, medicine, bioengineering, health care product development, third party payment, medical informatics, and national health policy to building a technology assessment information capacity. Of import to meeting this, the first charge of the congressional mandate for the council, is the members' ability to coalesce their sectorial interests into a group effort of needs assessment, systems design, product development, strategic planning, and marketing. Pamela Simerly deserves special recognition for her skill and perseverance in helping to plan the project, and in assembling, reviewing, and processing information used for the assessment program profiles. Leslie Hardy collected and organized descriptive infor- mation for many of the entries in the information and data reso',rrec nary of the ~ . ~ . . ~ ~rectory. Wallace Watertall and James Gormley provided advice on editorial matters and layout. Peter Goldschmidt's knowledge of information systems, medicine, and management made him a worthy consultant to the project. He brought systematic thinking and thoroughness to matters ranging from reviewing for relevance thousands of assess- ment report citations to setting the project within a long range plan. Grace McCarn provided insightful consultation regarding the needs and capabilities of the medical information community relevant to this project, including technical aspects of such matters as indexing, production, and market placement. Since the early stages of the project, we have sought counsel from leading institutions in management of health care information systems. The staff of the National Library of Medicine has been consistently forthcoming with constructive advice. NLM's Betsy Humphreys coordinated planning sessions with key library staff to share technological expertise and to formulate strategies for development of a broadly integrated technol- ogy assessment information base. The review undertaken by NLM staff of the Directory provides encouraging evidence of the utility of this body of information. Guidance concerning the design and implementation of information bases for the health commu- nity was provided by Eloise Foster and staff of the American Ho.snit~1 A.csori~tion Resource Center and by LeRoy Walters and stati of the K,~nneriv Inctir,,r`~ of Fthirc Georgetown University. HATE 1 __ 1 .1 .1 . ~ . ~ ~ ~CAM ~ ~V<~- HAVE AA ~BAND ^~_~] ISAAC._ ~F1 ~1~111~ YY ~ "l C V~1 y I Witi} til~ work or Ine 1 K1 1 ~1N corporation, which was responsible for assembling the information base of assessment program profiles and report cita- tions, indexing of citation records, and preparing camera-ready copy of the Directory. Meriting special recognition are Patricia President, who coordinated all aspects of the contractor's effort, and Linda Malcom, who had a key role in indexing a disparate and technical body of literature. This resourceful and adaptive group also included Patricia Chang and Karen Inscoe, who were resnon.sible for nrn~r~mmin~ car] Bits ~~7 corporate officer Edsel Billingy. --Rae rA~-~- ~ Finally, we thank the people associated with the organizations described in the Directory who completed surveys and forwarded other material incorporated here. Many of these individuals are shown as contact persons for the profiled assessment programs and the resource organizations in the Directory. Lawrence C. Morris, Chairman, Information Panel Clifford S. Goodman, Staff Officer v

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FOREWORD The Medical Technology Assessment Directory is the first major published work of the Council on Health Care Technology. The Directory is an introductory vehicle that organizes recent and current assessment information from a broad though not com- prehensive selection of assessment programs and related activities. With this edition, the council makes an overture to those with interests in medical technology assessment to become partners in building a wider and more integrated information network. How users respond to the Directory will help to determine which among a variety of ways this information capacity will evolve. The council was mandated by the U.S. Congress in the Health Promotion and Disease Prevention Amendments of 1984 (P.L. 98-551) and by technical amendments made in 1985 (P.L. 99-117~. The purpose of the council is to promote the development and application of technology assessment in health care and to review health care technol- ogies for their appropriate use. Provision for the council in P.L. 98-551 was the culmination of two streams of activity conducted under the auspices of the Institute of Medicine, National Academy of Sciences. The first was the initiative to create an entity, supported jointly by the private and public sectors, to enhance the assessment of medical technology. The second was a comprehensive study of the state of medical technology assessment. In December 1982, the Institute of Medicine established the Committee to Plan a Private/Public Sector Entity to Assess Technology in Medical Care under the chairman- ship of Jeremiah Barondess. The committee was charged with developing a plan for a technology assessment organization that would be based in the private sector but supported by both government and non-governmental parties~. This initiative grew out of an exploratory meeting convened by the Institute on June 16, 1982, in response to growing concerns in both the public and private sectors about the proliferation of technologies in medical care. These concerns were characterized by pressures to elimi- nate technologies that may be obsolete, harmful, or ineffective; desires to affirm the benefits of other technologies; and stringencies of the need to slow the growth of costs while maintaining and improving the quality of American medical care. The committee completed its work on June 30, 1983. The final report, published in November 1983, recommended the creation of a medical technology assessment con- sortium within the Institute of Medicine. The consortium was conceived of as seeking support divided approximately evenly between governmental and non-governmental resources. It was not intended as a competitor or as a replacement for any existing entity involved in assessing medical technologies. Rather, it was to be complementary and facilitative of the efforts of others involved in responsible assessments. As a first step, the consortium was to establish and maintain an information clearinghouse for medical technology assessment. This clearinghouse function would help to build a communication network among the principal parties to technology assessment, includ- ing other technology assessment entities, third party payers, major health care provid- ers, and others; serve to reduce unneeded or unrecognized redundancies in evalua- tion; establish a source of information on completed and ongoing assessments; provide a forum for all the parties at interest in the development and validation of technologies; and facilitate the dissemination of information on medical technology assessments. Subsequent to legislation enacting the ideas in the committee's report, the Council on Health Care Technology was formed in March 1986. At its first meeting in April 1986, the council created the Information Panel to plan and establish the clearinghouse. This Directory is the Information Panel's first substantive product. . V11

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MEDICAL TECHNOLOGY ASSESSMENT DIRECTORY Another Institute committee, the Committee for Evaluating Medical Technologies in Clinical Use, under the chairmanship of Frederick Mosteller, was charged with examin- ing the state of medical technology assessment. This study was begun following a 1980 Institute conference on linking the clinical use of biomedical technologies and the collection of evaluative data. Major areas addressed in the committee's 1985 study report, Assessing Medical Technologies2, included the scope of medical technology assess- ment in the U.S., methods of assessment, effects of clinical evaluation on the diffusion of medical technology, the relationship of assessment and reimbursement policy, as sessment activities In other countries, and papers on such topics as clinical trials, cost-effectiveness, and values and preferences in health care delivery. Also included were detailed profiles of 20 technology assessment programs in the U.S. and topics of their respective assessment reports. The work on the scope of medical technology assessment and the program profiles constituted important groundwork for this Direc- tory, just as the entire study report has been a touchstone for the deliberations of our council. On behalf of the Council on Health Care Technology, I trust you will find the Directory a useful working document. The council plans to expand and update the Directory periodically, and intends to make its information base available in a machine readable format. If you think that your organization, or another organization, has an assessment program that ought to be incorporated in an updated Directory, please let us know. We welcome your comments. William N. Hubbard, Jr., Chairman References 1. Institute of Medicine Committee to Plan a Private/Public Sector Entity to Assess Technology in Medical Care. Planning study report: a consortium for assessing medical technology. Washington, D.C.: National Academy Press, 1983. 2. Institute of Medicine Committee for Evaluating Medical Technologies in Clinical Use. Assessing medical technologies. Washington, D.C.: National Academy Press, 1985. ~ ~ vail

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PREFACE During the last decade, various sectors of the health care enterprise have taken a con- verging interest in determining the safety, effectiveness, cost-effectiveness, and social, ethical, and legal impacts of health care technologies. Each of these sectors physicians and other health professionals, patients and other consumers, biomedical researchers, health product makers, third party payers, health plan managers, institutional adminis- trators, academicians, public policy makers, and others tends to rely on some famil- iar, though different. set of literature and information sources in an attempt to meet assessment needs. Although more of the health care community has taken explicit interest in medical technology assessment, there remain inadequacies in the supply of good assessment information and the manner in which existing information is organized and made available to those who need it. I have learned as a committee member for the Institute of Medicine study Assessing Medical Technologies and from the perspective of a health care payer that the demand for assessment information is outstripping the aggregation of well conducted clinical trials, authoritative group judgments, surveillance studies, and other inquiries concerning medical technologies. Therefore, as we encourage an increase in competent assessment activity, we seek to assemble what good assessment findings there are, both from our traditional sources and from sources that are new to us. As the emerging field of medical technology assessment becomes the shared prov- ince of multiple health industry sectors, each one stands to benefit by gaining familiar- ity with and access to new information resources. Further, we seek to identify a coher- ent body of assessment literature from which all of us may benefit. In authorizing the Council on Health Care Technology, Congress specified establish- ment of a clearinghouse on medical technology assessment information. The Medical Technology Assessment Directory is the first major step toward fulfilling this purpose. It encompasses programs that produce medical technology assessments, information and data resources, and other organizations to which inquiries about medical technology can be directed. An important contribution of the Directory is to make a first attempt at organizing certain valuable "gray" or "fugitive" literature, i.e. technology assessments not published in widely circulated peer reviewed medicaljournals or accessible through the better known citation bases such as the National Library of Medicine's (NLM) MED- LARS (Medical Literature Analysis and Retrieval System). Thus, this Directory describes relevant mainstream information sources, and complements them with its collection of . . pertinent gray literature. Assessments cited in this first edition of the Directory are limited to those produced by organizations with an ongoing medical technology assessment program. Future ver- sions, whether in hard-copy or machine readable format, will expand coverage to in- clude more and different sources of literature. For purposes of indexing the assess- ment report citations, we have used NLM's MeSH (Medical Subject Headings) terms wherever possible. In the technology thesaurus particularly, we have begun to craft a controlled vocabulary that builds upon MeSH terms to make the indexing as relevant as practical to the technology assessment community. The Directory is intended to be a resource to the wider technology assessment communi- ty. We hope that this edition, with alphabetical listings of organizations, contact infor- mation, descriptions of activities, list of defined acronyms, indexes, and a thesaurus of technology terms designed to lead different types of users to assessments of interest, will be a worthy guide to this multidisciplinary field. Because it assembles and organizes .

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MEDICAL TECHNOLOGY ASSESSMENT DIRECTORY a strong sample of assessment activity rather than being an exhaustive compendium, we view it as a prototype for a more comprehensive, adaptive information base for medical technology assessment. The Directory is the first substantive product of the council's Information Panel. In future months and years, the Information Panel plans to work with the NLM to aug- ment the Library's MeSH vocabulary and certain files of organizational based informa- tion, produce access guides to standard literature sources, enhance and update the Directory, institute clearinghouse services, and establish online access to the Directory information base. We hope that the Directory will enhance communication in the assess- ment community, and will prompt greater participation in development of our clear . . . . ng. souse activities. Lawrence C. Morris, Chairman, Information Panel

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CONTENTS Introduction Guide to the Directory's Contents xxix Ways to Use the Directory Glossary of Acronyms . . . . . ... XV11 .............. xxxvii Part 1: Assessment Program Profiles and Report Citations American Academy of Neurology, Practice Committee 3 American Academy of Ophthalmology, Ophthalmic Procedures Assessment Program American Academy of Pediatrics American College of Cardiology/American Heart Association, Task Force on Assessment of Cardiovascular Procedures American College of Obstetricians and Gynecologists, Committee Opinions American College of Obstetricians and Gynecologists, Committee on Technical Bulletins American College of Physicians, Clinical Efficacy Assessment Project American College of Radiology, Task Force on Breast Cancer American Dental Association, Council on Dental Materials, Instruments, and Equipment American Dental Association, Council on Dental Therapeutics American Diabetes Association American Gastroenterological Association, Patient Care Committee American Hospital Association, Hospital Technology Series Program American Medical Association, Council on Scientific Affairs American Medical Association, Diagnostic and Therapeutic Technology Assessment Program American Medical Association, Drug Evaluations American Society for Gastrointestinal Endoscopy, Committee on Technology Assessment ............... Battelle Memorial Institute Blue Cross and Blue Shield Association, Medical Necessity Program Blue Cross and Blue Shield Association, Technology Evaluation and Coverage Program Brandeis University Health Policy Center, Organ Procurement Project California Medical Association, Medical Practice Opinion Program CBO National Organization for Quality Assurance in Hospitals, Consensus Development Program (Netherlands) College of American Pathologists, Surveys Program Congress of the United States, Office of Technology Assessment Health Program Duke University, Center for Health Policy Research and Education ECRI Health Devices Program ECRI Technology Assessment Program Food and Drug Administration (Overview) 93 Food and Drug Adminstration, Center for Devices and Radiological Health 94 Food and Drug Administration, Center for Drugs and Biologics 108 6 9 14 16 18 22 27 31 34 44 47 51 52 56 58 61 63 65 70 72 75 81 84 88 X1

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MEDICAL TECHNOLOGY ASSESSMENT DIRECTORY An information or data resource may be characterized by more than one descriptor for each of the three main types. For instance, a resource may have bibliographic as well as full text files, may appear in hard copy as well as online format, or may have both public and limited access files. The descriptions of each of the 73 information and data resources are arranged alphabetically by name of resource. Each is described according to the following common format. Name of information or data resource. Source gives the name, address, and telephone number of the organization that produces or makes available the information or data. Subject indicates the general subject matter covered by the information or data resource. Content describes the information or data contained in the resource, such as scope of coverage, file format, and descriptions of subfiles. Compilation describes how the information or data resource is assembled, such as primary sources, when compilation began, and how often the resource is updat- ed. Access describes how to acquire the information or data, including subscription and use charges, limitations to public access, need for computer hook-up, etc. At the end of Part 3 is a subject index for identifying information and data resources relevant to particular topics, e.g., market research. PART 4: ORGANIZATIONAL RESOURCES This part provides brief descriptions and contact information for 72 organizations that are active in affairs related to medical technology and are stakeholders in medical technology assessment. Although most of these organizations do not generate technol- ogy assessment reports on a regular basis, they have memberships concerned with medical technologies, conduct relevant meetings and symposiums, publish conference proceedings and other documents of note, establish standards for technologies, or are active in government, regulatory, or other policy affairs relevant to the field. The organizational descriptions are arranged alphabetically by organization name. Each includes name, address, and telephone number of the organization; contact personas), and a narrative description of the organization in 300 words or less, includ- ing discussion of medical technology related activities. At the end of Part 4 is a subject index for identifying organizations involved in particular areas, e.g., biomedical engi- neering. PART 5: INDEX TO ORGANIZATIONS This part includes an alphabetical listing with addresses and telephone numbers for all organizations described in the Directory, as well as a page index to the organizations. XXXV1

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WAYS TO USE THE DIRECTORY DO YOU WANT TO SEE IF AN ORGANIZATION IS LISTED, OR WHAT IT DOES? Check the index to organizations in Part 5 to find the Dames on which or~ani7.~tion.c Are described in the Directory. r ; ~A ~ A _ ~ ~ ~ t~ ~ A ~ ~- ~ ~ ~4 Hi_ ~ ~ ~ ~ At_ DO YOU WANT TO FIND ASSESSMENT REPORTS ON A SPECIFIC TECHNOLOGY? Check the technology thesaurus at the beginning of Part 2 on page 313. The thesaurus will inform you whether reports are listed under the technology term that you have in mind, or under a synonym or related term. Once you have located the appropriate term, you can find the pertinent report citations under that heading in Part 2. YOU MAY BE INTERESTED IN REPORTS THAT HAVE TITLES REFERRING TO TECHNOLOGY TERMS THAT ARE BROADER OR NARROWER THAN THE ONE YOU HAVE IN MIND. For example, if you are interested in reports about beta-blockers, you will find reports under the heading Beta-blockers. But, as the thesaurus indicates, additional reports are to be found under more specific names for beta-blockers, such as Propranolol. Except for cases in which more than one technology is shown in the title of a report citation, a citation is listed only once in Part 2, i.e. under the most specific technology heading. So, it is important to refer to the thesaurus first to get the most out of the listing of assessment report citations by technology in Part 2. DO YOU WANT TO FIND REPORTS INDEXED BY NON-TECHNOLOGY TERMS SUCH AS COST BENEFIT ANALYSIS, PARTICULAR DISEASES, OR OTHER SUBJECTS? Check under the desired term in the index to report citations at the end of Part 1, and use the report codes found there to look up the assessments in the indicated program profiles. Each code under that term has a two letter prefix indicating the assessment program in Part 1, and a number indicating the report's placement in the program's list of citations. A list of prefixes and their respective programs is shown immediately preceding this subject index. Under Cost benefit analysis, you would find the reference numbers BA2, CP3, CU62, etc., which correspond to the numbered assessment report citations following the profiles on Battelle Memorial Institute, College of American Pathologists, Congress of the United States Office of Technology Assessment, etc. Similarly, under Asthma, you would find AC110, MG14, and ND86; under Breast neoplasms are AE15, AH4, AH6, etc.; under Hypertension are AGO, BAT, HN28, etc., and under Postmarketing surveil- lance are CU56, HN79, MG9, and MG10. Because each assessment report citation is indexed with from one to five terms, a particular report citation may be shown under more than one term in the index to report citations at the end of Part 1. For instance, the 1987 report by the Medical Technology and Practice Patterns Institute, "Dialysis treatment for end stage renal disease (outpatient)," is indexed under the terms Dialysis; Kidney failure, Chronic; and - XXXV11

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MEDICAL TECHNOLOGY ASSESSMENT DIRECTORY Outpatients. This means that the code for that report, MT6, is shown under each of these three terms. For non-technology terms such as asthma, cost benefit analysis, or hypertension, the subject index to report citations relies primarily upon MeSFI terminology. The actual titles of the the aforementioned three reports indexed under Cost benefit analyses, i.e. BA2, CP3, and CU62, include the phrases "cost-effectiveness analysis, "cost-effective," and "Allocating costs and benefits," respectively. Cost benefit analysis is the MeSH index- ing term assigned for these. For technologies such as beta-blockers, coronary artery bypass grafting, or chorionic villi sampling, this index relies primarily upon the terms developed for the technology thesaurus in Part 2, which includes some MeSt[ terms. Searching for reports by technologies is best done using the technology thesaurus at the beginning of Part 2 because it shows cross-references, synonyms, and related terms. DO YOU WANT TO FIND REPORTS THAT ADDRESS MORE THAN ONE SUBJECT? This involves locating the set of reports common to the multiple subjects of interest. For instance, to find reports that address both cost benefit analysis and cervical cancer screening, note the reports listed under Cost benefit analysts in the subject index at the end of Part 1. Next, determine if any of these reports is also listed under Cancer screening Cervical in the index at the end of Part 1 or the listing of assessment report citations by technology in Part 2. Remember that the thesaurus at the beginning of Part 2 is the best guide in the Directory for locating reports by their technology subjects. Among the reports found under both Cost benefit analyses and Cancer screening Cervical is a report from the Congress of the U.S. Office of Technology Assessment, "Allocating costs and benefits in disease prevention: an application to cervical cancer screening." This manual approach of looking under two or more subject headings is necessary given that the Directory information base is available only in hard-copy format at the time of printing this first edition. In a computer format, the "and/or" operations of Boolean algebra could be used more readily for searching reports involving such constraints as multiple subjects. DO YOU WANT TO OBTAIN A TECHNOLOGY ASSESSMENT REPORT? Check the subject index to assessment report citations at the end of Part 1 or the listing of assessment report citations by technology in Part 2 to find out which assessment program produced it. Find the program's profile in the alphabetical listing of assess- ment programs in Part 1, and see the section on Dissemination for ordering information. The program's address, telephone number, and other contact information are shown at the beginning of the profile. DO YOU WANT TO GET IN TOUCH WITH AN ORGANIZATION THAT DEALS WITH A CERTAIN TOPIC? Use the subject indexes to the different parts of the Directory to identify organizations active in certain areas. The index to report citations at the end in Part 1 and the listing of assessment report citations by technology in Part 2 may be used to identify profiled assessment programs, arranged alphabetically in Part 1, by the topics of their assess- ment reports. The information and data resources in Part 3 and the organizational resources in Part 4 are indexed by subject at the ends of those parts. For instance, under - - XXXV111

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WAYS TO USE THE DIRECTORY the heading Market research in the index to information and data resources in Part 3 are listed IMS Audits, Scrip, Market/Technology Reports (Biomedical Business Interna- tional), and other resources. Under the heading Biomedical engineering in the index to organizational resources in Part 4 are listed the Alliance for Engineering in Medicine and Biology, American Society of Mechanical Engineers, RESNA-Association for the Advancement of Rehabilitation Technology, Institute of Electrical and Electronics Engineers, and the International Federation for Medical and Biological Engineering. Contact information and descriptions of these are arranged alphabetically. xxx~x

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GLOSSARY OF ACRONYMS AABB AAD AAFP AAN AAO AATB ACC ACEP ACG ACNP ACOG ACP ACPM ACR ACS American Association of Blood ACT Banks American Academy of Derm- ADA atology American Academy of Family Physicians AAMC Association of American Medical Colleges AAMI Association for the Advancement of Medical Instrumentation AAMSI American Association for Medical Systems and Informatics American Academy of Neurology American Academy of Ophthal mology AAOHNS American Academy of Otolaryn gology-Head and Neck Surgery AAOS American Academy of Orthopaedic Surgeons AAP American Academy of Pediatrics AAPMR American Academy of Physical Medicine and Rehabilitation American Association of Tissue Banks American College of Cardiology American College of Emergency Physicians American College of Gastro enterology American College of Nuclear Physicians American College of Obstetricians and Gynecologists American College of Physicians American College of Preventive Medicine American College of Radiology American Cancer Society or American College of Surgeons American Council on Transplan- tation American Dental Association or American Diabetes Association ADAMHA Alcohol, Drug Abuse, and Mental Health Administration ADM AEMB AGS AHA AHCI AHSR AIUM alcohol, drug abuse, and mental health Alliance for Engineering in Medicine and Biology American Geriatrics Society American Hospital Association or American Heart Association American Health Care Institute Association for Health Services Research American Institute of Ultrasound in Medicine AMA American Medical Association AMCRA American Medical Care and Review Association AMPRA American Medical Peer Review Association AAMRC American Medical Review Research Center American National Standards Institute Associated Press American Psychiatric Association American Public Health Association American Rheumatism Association American Society of Anesthe SiOlO~StS ASCP American Society of Clinical Pathologists ASCPT American Society for Clinical Pharmacology and Therapeutics ANSI AP APA APHA ARA ASA xli

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ASGE ASIM ASTM ASTP ASTS AUA AZT BCBS BCDSP BDDD 1BERC American Society for Gastrointestinal Endoscopy American Society of Internal Medicine ASPEN American Society of Parenteral and Enteral Nutrition American Society of Testing and Materials American Society of Transplant Physicians American Society of Transplant Surgeons American Urological Association azidothymidine Blue Cross and Blue Shield Boston Collaborative Drug Surveillance Program Division of Birth Defects and Developmental Disabilities (CDC) Bureau Eligibility, Reimbursement and Coverage (HCFA) BMEDSS Biomedical Engineering Decision Support Services BRS Bibliographic Retrieval Service CABG coronary artery bypass grafting CAMMD Canadian Association of Manu facturers of Medical Devices CAP College of American Pathologists CASSIS Classification and Search Support Information System (Patent and Trademark Office) CAT CBO CCC CDB CDC , X111 CPHA CPT-4 computerized axial tomography Centraal Begeleidingsorgaan voor de Intercollegiate Toetsing (The Netherlands) Copenhagen Collaborating Center (WHO) Center for Drugs and Biologics (FDA) Centers for Disease Control CRISP CSDD CSS CT CVS MEDICAL TECHNOLOGY ASSESSMENT DIRECTORY CDRH Center for Devices and Radiological Health (FDA) CEAP Clinical Efficacy Assessment Project (ACP) CFSAN Center for Food Safety and Applied Nutrition (FDA) CHA Center for Health Affairs (Project HOPE) CHAMPUS Civilian Health and Medical Program of the Uniformed Services CHID Combined Health Information Database CHPE Center for Health Promotion and Education (CDC) CHPRE Center for Health Policy Research and Education (Duke University) CMA California Medical Association CMSS Council of Medical Specialty Societies CMT Center for Medical Technology Assessment (Linkoping University) COMPASS Computerized On-Line Medicaid Pharmaceutical Analysis and Surveillance System (Health Information Designs, Inc.) Commission on Professional-and Hospital Activities Current Procedural Terminology, 4th Edition Computer Retrieval of Information on Scientific Projects (NIH) Center for the Study of Drug Development (Tufts University) Council of Subspecialty Societies computed tomography chorionic villi sampling DATTA Diagnostic and Therapeutic Technology Assessment Program (AMA)

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DCCC Duke Comprehensive Cancer GFIC Center Database DEN Device Experience Network (FDA) GPIA DHHS U.S. Department of Health and Human Services GPO Department of Health and Social GWUMC Security (United Kingdom) DIMDI Deutsches Institut fur Medizinische HANES Dokumentation und Information (Germany) HBP DIRLINE Directory of Information Resources HCFA U.S. Department of Defense Drug Product Problem Reporting System (FDA, USP) HHS diagnosis-related group or Division of Research Grants (NIH) DURbase Drug Utilization Review base (Health Information Designs, HIMA Inc.) Employee Benefit Research Institute formerly Emergency Care Research Institute ECRI/HDP ECRI Health Devices Program HSR&D ECRI/TAP ECRI Technology Assessment IAF Program Division of Environmental Health Laboratory Sciences (CDC) EMBASE Excerpta Medica Database (Elsevier) EPA Environmental Protection Agency IEEE ERIC Educational Resources Information Center DHSS DOD DPPR DRG EBRI ECRI EHLS Group Health Cooperative of Puget Sound Generic Pharmaceutical Industry Association U.S. Government Printing Off~ce George Washington University Medical Center National Health and Nutrition Examination Survey (NCHS) high blood pressure Health Care Financing Administration (DHHS) HECLINET Health Care Literature Infor mation Network (DIMDI) U.S. Department of Health and Human Services HIAA HMO HRSA ESRD end stage renal disease FAHS Federation of American Health Systems FDA Food and Drug Administration IFVHSF GHAA Group Health Association of America Health Insurance Association of America Health Industry Manufacturers Association health maintenance organization Health Resources and Services Administration Health Services Research and Development Service (VA) Institute for Alternative Futures ICD-9-CM International Classification of Diseases, 9th Revision, Clinical Modification IDE investigational device exemption (FDA) Institute of Electrical and Electronics Engineers IFMBE International Federation for Medical and Biological Engineering Institute for the Future IFTF International Federation of Voluntary Health Service Funds , x'~

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MEDICAL TECHNOLOGY ASSESSMENT DIRECTORY IHPS IND IOM IRCS MDR NAM Institute for Health Policy Studies (UCSF) IMPAC Information for Management Planning Analysis and Coordination (NIH) investigational new drug (FDA) Institute of Medicine (NAS) International Research Communications System (Elsevier) ISTAHC International Society of Technology Assessment in Health Care Medical Device Reporting regulation (FDA) MEDITEC Medizinische Technik MEDLARS Medical Literature Analysis and Retrieval System (NLM) MEDLINE MEDLARS online (NLM) MeSH Medical Subject Headings (NLM) MHA Maryland Hospital Association MHRST Medical and Health Related Sciences Thesaurus (NIH) MRC Medical Research Council (Canada) MTPPI Medical Technology and Practice Patterns Institute NAHDO National Association of Health Data Organizations National Association of Manu facturers NAS National Academy of Sciences NASA National Aeronautics and Space Administration NCEP National Cholesterol Education Program NCHS National Center for Health Statistics NCHSR/ National Center for Health HCTA Services Research and Health Care Technology Assessment xliv NCI National Cancer Institute NCQHC National Committee for Quality Health Care NDA new drug application (FDA) Nd:YAG Neodymium:yttrium aluminum garnet NEMA National Electrical Manufacturers Association NEMT Nordic Evaluation of Medical Technology NHC National Heart Council NHLBI National Heart, Lung, and Blood Institute NHRDP National Health Research and Development Program (Canada) NHS National Health Service (United Kingdom) NHSPPS National Health Services and Practice Patterns Survey NIA National Institute on Aging NIAAA National Institute on Alcohol Abuse and Alcoholism NICHD National Institute of Child Health and Human Development NIDA National Institute on Drug Abuse NIH National Institutes of Health (PHS, DHHS) NIMH National Institute of Mental Health NINCDS National Institute of Neurological and Communicative Disorders and Stroke NIOSH National Institute for Occupational Safety and Health NLM NMR NSEP National Library of Medicine nuclear magnetic resonance NHLBI Smoking and Education Program NTIS National Technical Information Service

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GLOSSARY OF ACRONYMS OASH Office of the Assistant Secretary for Health (DHHS) ODPHP Office of Disease Prevention and Health Promotion (DHHS) OHTA Office of Health Technology Assessment (NCHSR) OMAR Office of Medical Applications of Research (NIH) ONHIC ODPHP National Health Information Center Office of Planning and Evaluation (NIH) Organ Procurement and Trans plantation Network (UNOS) Office of Research and Demonstrations (HCFA) Occupational Safety and Health Administration Office of Technology Assessment (U.S. Congress) Pan American Health Organization Physician Data Query (NCI) U.S. Public Health Service (DHHS) Pharmaceutical Manufacturers Association PPRC or Physician Payment Review PhysPRC Commission PPS Medicare Prospective Payment System PRO professional review organization ProPAC Prospective Payment Assessment Commission Medical Device and Laboratory Product Problem Reporting Program (FDA, USP) PTO U.S. Patent and Trademark Office R&D research and development RESNA Association for the Advancement of Rehabilitation Technology, formerly Rehabilitation Engineering Society of North America OPE OPTN ORD OSHA OTA PAHO PDQ PHS PMA PRP RCT randomized (controlled) clinical trial RFA RFP SBA SEER SMD request for application request for proposal RPA Renal Physicians Association RTECS Registry of Toxic Effects of Chemical Substances (NIOSH? NLM) Summary Basis of Approval (FDA) Surveillance, Epidemiology, and End Results Program (NCI) Standard Industrial Classification Society for Medical Decision Making SNM Society of Nuclear Medicine SNIVT Society of Non-Invasive Vascular Technology Special Projects Office (VA) Swedish Planning and Ration alization Institute of the Health Services SPRILINE Swedish Planning and Ration alization Institute of the Health Services line SPO SPRI SREPCIM Society for Research and Education in Primary Care Internal Medicine SSED TAF TDC TNO UCSF UHC UNOS USDA Summaries of Safety and Effectiveness Data (FDA) Technology Assessment and Forecast Program (PTO) Technical Data Center (OSHA) Medical Technology Unit, Netherlands Organization for Applied Scientific Research University of California at San ~ . ranasco University Hospital Consortium United Network for Organ Sharing U.S. Department of Agriculture xlv

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MEDICAL TECHNOLOGY ASSESSMENT DIRECTORY USDHHS U.S. Department of Health and Human Services VA Veterans Administration xlvi WHO World Health Organization YAG yttrium aluminum garnet