Diffusion of Interventional Radiology and Health Technology Assessment: the case of radiofrequency treatment in oncology

Interventional Radiology (IR) is a subdivision of the radiological specialty consisting of none or minimally invasive image-guided ambulatory interventions. It is one of many leading medical innovations that have great potential in the treatment of several pathologies. Yet the diffusion of this innovation is substantially slow considering its age. IR is faced with several problematics preventing its diffusion concerning disciplinary conflicts, the control of the market by dominant production companies and rival techniques. Health Technology Assessment (HTA) is a healthcare evaluation consisting in the comparison of a series of interventions to establish a hierarchy between them, taking into consideration not only the efficiency of a technique but also its cost. HTA contributes to the recognition of an innovation thus leading to its diffusion. The purpose of this study is to evaluate to which extent and speed has IR been the subject of HTAs by measuring the bibliographic data related to them. In this study, we focused on RFA for lung metastasis of colorectal cancer since it was identified as the most problematic technique by the Comprehensive Cancer Center. We carried out a database consultation gathering data on the evolution of the concepts in hand. Finally we retrieved pertinent articles and analyzed them, identifying cost and effectiveness indicators. The results show that the evolution of IR publications and HTA related IR publications are relatively slow. Yet the technique RFA has known great interest by both authors and the public accompanied by an explosion of its use. Both the innovation and its evaluation are influenced by the interest of the public in it. The leading publishing countries were the USA and the UK. France was far behind in the HTA related IR publications compared to other countries in the region.