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February 7, 2007

Potential Health and Economic Consequences of Misplaced Priorities

Author Affiliations

Author Affiliations: Departments of Family Medicine, Epidemiology, and Community Health, Virginia Commonwealth University, Richmond.

JAMA. 2007;297(5):523-526. doi:10.1001/jama.297.5.523

To maximize the health of its citizens, society should pursue interventions in proportion to the ability of those interventions to improve outcomes. All else being equal, a strategy that is more effective than its alternative should receive more, not less, attention. Doing otherwise can compromise the health of patients. For example, if intervention A is 10 times more effective than intervention B in reducing mortality, performing more of B than A will allow more deaths to occur. Just as errors of omission cause harm, inattention to how priorities are balanced can indirectly claim lives, contribute to disease, and generate costs that would not occur if priorities were in greater harmony with potential gains.