focus was on whether or not to screen for a condition. Teutsch responded that one needs to have a specific clinical scenario in mind, and that assessments should not be done in the abstract.

Another participant expressed concern about the decision matrixes considering low efficacy and harm as if they were similar in impact, and suggested that a distinction be made. Teutsch said the vocabulary varies, but in his perspective, efficacy refers to benefits, and effectiveness refers to the balance of the benefits and potential harms. On some occasions, risk of substantial harm may be acceptable because of the potential for substantial benefits, while at other times the equation will be different. He agreed there is a need to be clear about whether one is talking about benefits or harms, and to whom they accrue.