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June 1, 1984

The Role of Decision and Cost Analyses in the Treatment of Pregnant Women With Recurrent Genital Herpes

Author Affiliations

University of Washington School of Public Health and Community Medicine The Fred Hutchinson Cancer Research Center Division of Public Health Sciences Seattle; University of Washington School of Public Health and Community Medicine Seattle

JAMA. 1984;251(21):2828-2829. doi:10.1001/jama.1984.03340450044025

The techniques of cost-benefit, cost-effectiveness, and clinical-decision analyses provide theoretical frameworks for systematic evaluation of the consequences of medical care programs or policies. For a specific medical problem, these techniques help evaluate the attainment of the "greatest social good," given the limited availability of health resources.1 The analyses, in and of themselves, are limited by the difficulty in determination of values concerning quality-of-life issues and by the model's inability to incorporate political and medicolegal concerns and clinical reality.2 Thus, these tools are usually intended, from a societal perspective, to complement and enhance, not replace, health policy decision making and clinical judgment.3 For complex issues, these analytic tools can help clarify points of agreement and disagreement regarding assumptions, probabilities, values, and what additional information is needed from future studies.4

In this issue of The Journal, Binkin et al,5 by using decision analysis in combination with cost-effectiveness analysis,

Warner KE,  Luce BR: Principles: The methodology of CBA-CEA , in  Cost Benefit and Cost Effectiveness Analysis in Health Care . Ann Arbor, Mich, Health Administration Press, 1982, pp 60-115.
McLaughlin CP:  Cost benefit and cost effectiveness analysis , in Bloom BS, DeFriese GH (eds):  Cost Benefit, Cost Effectiveness, and Other Decision-Making Techniques in Health Care Allocation. Proceedings of a Regional Symposium, Port St Lucie, Fla, Feb 3-5, 1983 , New York, Biomedical Information Corporation Publications, 1983, pp 11-18.
Weinstein MC, Fineberg HV, Elstein AS, et al:  Clinical Decision Analysis . Philadelphia, WB Saunders Co, 1980.
Weinstein MC, Stason WB:  Foundations of cost effectiveness analysis for health and medical practices .  N Engl J Med 1977;296:716-721.Crossref
Binkin NJ, Koplan JP, Cates W Jr, et al:  Preventing neonatal herpes: The value of weekly viral cultures in pregnant women with recurrent genital herpes .  JAMA 1984;251:2816-2821.Crossref
Committee on Fetus and Newborn and Committee on Infectious Diseases:  Perinatal herpes simplex virus infections .  Pediatrics 1980;66:147-149.
Sullivan-Bolyai J, Hull HF, Wilson C, et al:  Neonatal herpes simplex virus infection in King County, Washington: Increasing incidence and epidemiologic correlates .  JAMA 1983;250:3059-3062.Crossref
Vontver LA, Hickok DE, Brown Z, et al:  Recurrent genital herpes simplex virus infection in pregnancy: Infant outcome and frequency of asymptomatic recurrences .  Am J Obstet Gynecol 1982;143:75-84.
White JE: An Investigation of the Relationship Between Cesarean Births and Respiratory Distress Syndrome of the Newborn, dissertation. University of Washington, Seattle, 1982.