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Comment & Response
March 2018

Drivers of Low-Value Care—Reply

Author Affiliations
  • 1University of Texas Southwestern Medical Center, Dallas
  • 2Harvard Medical School Department of Population Medicine and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
JAMA Intern Med. 2018;178(3):433-434. doi:10.1001/jamainternmed.2017.8537

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.