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March 4, 1998

Potentially Ineffective Care in Intensive Care

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(9):651-654. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-9-jbk0304

To the Editor.—The data presented by Drs Cher and Lenert1have had an overly broad and misleading interpretation, both in the Article and in the news coverage.2,3The press release from THE JOURNAL claimed, "Managed care physicians may do a better job limiting unnecessary end-of-life treatment." The study does not show this to be true. The data would be consistent, for example, with an injudicious 20% cut in all utilization, which would lead to generally early discharge, thus incurring the 8% excess mortality in the 100 days after discharge.