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Resource allocation: beyond evidence-based medicine and cost-effectiveness analysis

1997; American College of Physicians; Volume: 127; Issue: 3 Linguagem: Inglês

10.7326/acpjc-1997-127-3-a16

1539-8560

Peter Singer,

Health Systems, Economic Evaluations, Quality of Life

EditorialNovember 1, 1997Resource allocation: beyond evidence-based medicine and cost-effectiveness analysisPeter A. Singer, MD, MPHPeter A. Singer, MD, MPHUniversity of Toronto, Toronto, Ontario, Canada (P.A.S.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-1997-127-3-A16 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinkedInRedditEmail You are sitting at your desk reading the latest issue of ACP Journal Club. The telephone rings. It's the CEO of your hospital (or managed care organization), who says, "The cardiac program has run up a $1 million unbudgeted expense in angioplasty stents in the past fiscal year. We can't afford it. Could you look into it and see whether these gizmos are worth it?"Is this a question of evidence-based medicine (EBM)? Is it a question of cost-effectiveness analysis (CEA)? The answer to both questions is "yes," but more fundamentally, it is a question of resource allocation. This editorial ...References1 McKneally MF, Dickens BM, Meslin EM, Singer PA. CMAJ. 1997;157:163-7. Google Scholar2 Haynes RB, Sackett DL, Gray JM, Cook DJ, Guyatt GH.Transferring evidence from research into practice: 1. The role of clinical care research evidence in clinical decisions. ACP J Club. 1996 Nov-Dec;125:A14-6. Google Scholar3 Evidence-Based Medicine Working Group. JAMA. 1992;268:2420-5. Google Scholar4 Cook DJ, Guyatt GH, Laupacis A, Sackett DL. Chest. 1992;102(Suppl 4): 305S-11S. Google Scholar5 Russell LB, Gold MR, Siegel JE, Daniels N, Weinstein MC. JAMA. 1996;276:1172-7. Google Scholar6 Tengs TO, Adams ME, Pliskin JS, et al. Risk Anal. 1995;15:369-90. Google Scholar7 Laupacis A, Feeny D, Detsky AS, Tugwell PX. Can Med Assoc J. 1992;146: 473-81. Google Scholar8 Detsky AS, Naglie IG. Ann Intern Med. 1990;113:147-54. Google Scholar9 Daniels N. Hastings Cent Rep. 1994;24:27-9. Google Scholar10 Taurek J. Philosophy and Public Affairs. 1977;6:293-316. Google Scholar11 Broome J. Hastings Cent Rep. 1994;24:36-9. Google Scholar12 Rakowski E. Hastings Cent Rep. 1994; 24:33-6. Google Scholar13 Nord E. J Med Ethics. 1993;19:37-42. Google Scholar14 Nord E, Richardson J, Street A, Kuhse H, Singer P. Soc Sci Med. 1995;41:1429-37. Google Scholar15 Ubel PA, DeKay ML, Baron J, Asch DA. N Engl J Med. 1996;334:1174-7. Google Scholar16 Kamm FM. Hastings Cent Rep. 1994, 24: 29-32. Google Scholar17 Naylor CD.Cost-effectiveness analysis: Are the outputs worth the inputs?. ACP J Club. 1996 Jan-Feb;124:A12-4. Google Scholar18 Hadorn DC. JAMA. 1991;265:2218-25. Google Scholar19 Bailey MA. Hastings Cent Rep. 1994;24: 39-42. Google Scholar20 Deber RB. Int J Technol Assess Health Care. 1992;8:131-7. Google Scholar21 Wiktorowicz M, Deber R. Health Policy. 1997;40:1-24. Google Scholar22 Eddy DM. JAMA. 1996;275:650-7. Google Scholar23 Deber RB, Goel V. Med Decis Making. 1990;10:181-94. Google Scholar24 Eddy DM. JAMA. 1991;266:2135-41. Google Scholar25 Kitzhaber JA. BMJ. 1993; 307:373-7. Google Scholar26 Government Committee on Choices in Health Care. Choices in Health Care. Rijswik, Netherlands: Ministry of Welfare, Health, and Cultural Affairs; 1992. Google Scholar27 Deber R, Narine L, Baranek P, et al. The Public/Private Mix in Health Care. Ottawa: National Forum on Health, 1997; [In press]. Google Scholar28 Canadian Medical Association. Core and Comprehensive Health Care Services: A Framework for Decision Making. Ottawa: Canadian Medical Association; 1994. Google Scholar29 Giacomini M. Centre for Health Economics and Policy Analysis Working Paper 97-1. Hamilton, Ontario: McMaster University; March 1997. Google Scholar30 Etchells E, Singer PA, Lazzam C, et al. Toronto: University of Toronto Joint Centre for Bioethics; 1996. Google Scholar31 Almond D, Chisholm R, Cohen E, et al. CCN Expert Panel on Intracoronary Stents: Final Recommendations. Toronto: Cardiac Care Network of Ontario; 1997. (Full text available through the CCN website, www.ccn.on.ca/) Google Scholar32 Mason J, Drummond M, Torrance G. BMJ. 1993;306:570-2. Google Scholar33 Russell LB, Gold MR, Siegel JE, Daniels N, Weinstein MC. JAMA. 1996;276:1172-7. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Toronto, Toronto, Ontario, Canada (P.A.S.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails November 1, 1997Volume 127, Issue 3Page: A16KeywordsAngioplastyAtrial fibrillationCancer treatmentCase seriesClinical epidemiologyCohort studiesCoronary arteriesDecision makingEvidence based medicineHealth careHealth economicsHemorrhageLesionsPatient advocacyPrevention, policy, and public healthProstate cancerQuality of lifeRadical prostatectomyStent implantationStroke ePublished: 9 March 2020 Issue Published: November 1, 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.Loading ...