Effectiveness and Outcomes in Health Care Proceedings of an Invitational Conference (1990) / Chapter Skim
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Pages 213-217
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PART V Where Do We Go From Here?
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The question reads as follows: "This conference and the work that preceded it have occurred because (a) key decision makers have become devoted to the improvement of knowledge about the linkage between medical interventions and medical outcomes OR (b)
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And even then we may not be sure because the studies now under way include only a tiny part of the universe of possible studies." The second reason I think expectations are bound to be disappointed is that, even if the direct result of effectiveness research is to save money on certain forms of care, the net saving will be reduced by the cost of the additional therapies that would prove necessary, either currently or at some time in the future. To illustrate the difficulty of deciding whether something reduces costs or not, consider the case of antibiotics.
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From page 217... ...
If so, this disjunction between hope and reasonable expectation raises an acutely difficult problem for persons who believe, correctly, that effectiveness research is worth doing. If those persons tell funders what they want to hear, they are going to be lying and the funders will find out sooner or later.
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