[The opinion of practitioners and internists on the impact of health technologies introduced in the last 25 years]. / Las tecnologías médicas más relevantes de los últimos 25 años según la opinión de médicos generalistas.

OBJECTIVES: To identify the most important health technologies (HT) introduced in the last 25 years and their impact on patients' health according to hospital internists and generalist physicians. METHODS: We performed a cross-sectional descriptive study. The 30 HT receiving the highest number of bibliometric citations in the previous 25 years (1977-2002) in generalist and primary care journals were selected. To assess the health impact of HT, a postal survey of the medical heads of 46 hospitals with 100-400 beds and an equal random sample of the directors of primary care centers was carried out in Catalonia, Spain. The professionals surveyed were asked to consider how adverse the effect on their patients' health would be if each of the HT on the list were unavailable. The personal and professional characteristics of the participating physicians were also collected. RESULTS: A total of 49 physicians answered the survey (53%). Instrumental and diagnostic technologies were considered to have the greatest impact on health, diagnostic imaging being the most highly scored. The lowest impact would be caused if some drugs were not available, hypoglycemic agents receiving the lowest scores. Although assessments were similar regardless of professional/practice characteristics (r > or = 0.7), some differences in diagnostic HT were observed, as well as variability in the participants' responses. CONCLUSIONS: Assessment of the impact of HT from the physicians' point of view varied. However, diagnostic and instrumental-visual technologies seem to be more highly rated than pharmacological innovations. Variability in responses was more closely related to the physicians' personal characteristics than to practice setting.