In Reply We appreciate the comments by Hahn and Gould highlighting the shortcomings of existing data to understand low-value care, and we commend them on their research examining the clinical granularity of data that relies on diagnostic coding. Misclassifying a clinically appropriate service as low-value in our study1 is an inherent limitation of using claims data. We would also note that misclassification can function in the other direction; that is, events excluded from the low-value category may be clinically inappropriate.
Hong AS, Ross-Degnan D, Wharam JF. Drivers of Low-Value Care—Reply. JAMA Intern Med. 2018;178(3):433–434. doi:10.1001/jamainternmed.2017.8537
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