John F. Schneider, MD, PhD
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To the Editors: The article by Drs. Detsky and Naglie (1) provides an excellent description of the process of cost-effectiveness analysis. The authors emphasize the use of cost-effectiveness analysis in political decision making and the need for involvement in and understanding of this activity by physicians. However, I believe the authors incorrectly minimized the value of cost-effectiveness analysis for physicians making decisions about care of individual patients. In Canada, national health insurance protects all patients from personal costs when they receive care. In the United States, however, monetary costs can be expected to influence a patient's decision on therapy. A
Schneider JF. Clinical Decision Analysis. Ann Intern Med. ;114:98. doi: 10.7326/0003-4819-114-1-98_1
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Published: Ann Intern Med. 1991;114(1):98.
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