Imaging and biochemistry are amongst the most rapidly evolving fields within medicine. In the last 30 years, clinical practice has been transformed by the rapid expansion of sophisticated new technologies in those fields offering a large range of instruments for better identifying, monitoring and sometimes predicting pathological processes.
As compared to therapeutic interventions, one of the main problems is the lack of standard procedures for validating new tools before their widespread application. This is mostly related to the complexity of the validation process, which requires a multidisciplinary approach involving technology assessment, efficacy (including effectiveness and efficiency) and outcomes, generating sometimes biases in the evaluation of the capability of the tool.
An additional problem is related to the typology of the new technology under study. In the imaging field is quite easy to demonstrate the technical improvement in the detection of the pathological process: magnetic resonance imaging (MRI) visualize better than computed tomography (CT) the brain lesions, as well as MRI or ultrasound visualize joint synovitis in rheumatoid arthritis (RA) patients better than CT or conventional radiography (CR).
Therefore nearly all publications in imaging are focused on technical and diagnostic performances of the new instruments and few studies are performed on the real impact of the use of those techniques for the therapeutic and clinical management of patients. Moreover when such studies are performed, they are far to show a real improvement in the management of patients in term of diagnostic cost, treatment or quality of life.
The objective of the presentation is to discuss the indications and possible biais in the application of imaging in rheumatic diseases.
Disclosure of Interest None declared
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