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Comment & Response
December 2017

Considerations Concerning Disease Redefinition—Reply

Author Affiliations
  • 1Centre for Research in Evidence Based Practice, Bond University, Gold Coast, Australia
  • 2Department of Clinical Policy, American College of Physicians, Philadelphia
JAMA Intern Med. 2017;177(12):1873. doi:10.1001/jamainternmed.2017.6155

In Reply We thank Dr Yang and colleagues for raising important points regarding our Special Communication1 on modifying disease definitions, many of which we alluded to in our article but that we agree need further discussion.

We agree with Dr Yang and colleagues that when modifying a disease definition, it is essential to consider whether the additional patients classified with the expanded definition warrant clinical intervention, as well as whether this net benefit should be paid for. Such decisions should include consideration of the regional variations in the values of the population concerned and their available resources. In our checklist, we recommended that the definition should reflect the values and preferences of patients and the wider community and include the impact on resource usage.1

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