PET Scans and Technology Assessment

The appearance in this issue ofJAMAof both a report of the Positron Emission Tomography (PET) Panel of the Council on Scientific Affairs of the American Medical Association¹and four letters²criticizing an evaluation of magnetic resonance imaging (MRI) evaluations and an accompanying editorial published in June³,⁴has prompted this editorial on proposed standards for the early evaluation of new technology. Although the randomized control trial has been recognized for 40 years as the standard for evaluation of new therapies, scientific techniques of assessing diagnostic tests are relatively recent. There are classic articles on the subject,⁵⁻¹¹and it is well covered in two recent books.¹²,¹³ It is of note that the protesting letter writers are all radiologists, as are most of the pioneers in developing the techniques of evaluation that the letters criticize. Technological advances of the last 20 years have presented physicians and