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May 1986

Is Prevention Better Than Cure?

Arch Surg. 1986;121(5):614. doi:10.1001/archsurg.1986.01400050132018

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


It is common knowledge that an ounce of prevention is worth a pound of cure, but the author of this challenging book is not so certain. In a typically Brookings Institute, scholarly way, she dissects the available data on prevention vs cure for conditions varying from smallpox and measles through hypertension and atherosclerotic heart disease. En route, she finds room to demolish more myths about the cost-effectiveness of cancer screening. Sacred dogmas fall like ten-pins.

The book begins by exposing the fallacies of our usual accounting system for both the costs and benefits of health care. In lieu of the customary survival statistics, the author reviews the several ways by which the quality of life can be measured and emerges with a unit called "years of healthy life." Each perfectly healthy year or day can be quantified by equating 1.0 with perfect health and equating 0 with death. If her

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