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April 5, 1995

Rationing Resources While Improving Quality

Author Affiliations

Salt Lake City, Utah

JAMA. 1995;273(13):995. doi:10.1001/jama.1995.03520370035019

To the Editor.  —After reading the article by Dr Eddy,1I was left with an uneasy feeling that the cost-benefit analyses he describes might not meet the requirements of peer review usually applied to validate the results of other scientific assertions. Accordingly, a decision to change one's practice based on a cost-benefit analysis conducted at the behest of an insurer may not be the best decision a physician can make for his or her patient. I entertain these doubts at the risk of being thought a backward curmudgeon of the "just to be on the safe side" school.I suggest that cost-benefit analyses such as Eddy describes should be published in the peer-reviewed medical literature, just as other scientific studies are. Further, it seems appropriate that insurers restrain themselves from creating "complementary coverage policies or guidelines" until the particular cost-benefit analysis and its assumptions can be considered in the

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