Although the clinical benefits of minimally invasive surgery are well known, the study by Epstein et al1 in this issue of JAMA Surgery provides a much broader perspective. Traditional clinical research asks a relatively narrow but important question: “Is this procedure better for this patient?” Dr Epstein, a health economist at the University of Pennsylvania, and his colleagues instead ask the question, “Is the trend toward less invasive procedures better for society?” The answers to these two questions are not necessarily the same. Less invasive procedures could provide clinical benefits to patients but increase the costs to society. Indeed, in most industries outside health care, higher quality costs more.
Dimick JB, Ryan AM. Taking a Broader Perspective on the Benefits of Minimally Invasive Surgery. JAMA Surg. 2013;148(7):648. doi:10.1001/jamasurg.2013.160