To the Editor In the absence of a randomized clinical trial, evaluating underlying market trends and risk is critical to determining whether an intervention resulted in real improvements in quality or costs. Unfortunately, Dr Lee and colleagues1 included neither in an observational study of a value-driven outcomes program that found reduced costs and improved quality in 3 clinical projects.
William B. Weeks. Evaluating a Value-Driven Outcomes Program. JAMA. 2016;316(23):2548–2549. doi:10.1001/jama.2016.17827