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October 4, 1995

Medical Technology Watchdog Plays Unique Role in Quality Assessment

JAMA. 1995;274(13):999-1001. doi:10.1001/jama.1995.03530130005001

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LAST FALL, when medical science and politics clashed over whether health insurers should be required to pay for high-dose chemotherapy plus autologous bone marrow transplants (ABMT) for patients with advanced breast cancer, a nonprofit independent technology assessment group called ECRI weighed in with something no one else had provided: a careful analysis of all the available published data.

ECRI's report, which came on the heels of a federal directive ordering government employees' insurance carriers to cover the costs of the controversial treatment, analyzed 40 studies of ABMT and similar procedures and 61 studies of patients receiving conventional chemotherapy.

The group's analysts concluded that the available data suggest that ABMT not only fails to extend the lives of women with advanced, metastatic breast cancer, but also is likely to be life shortening—although they cautioned that their findings reflect only the current state of the technology and are subject to revision as

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