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Healthy Skepticism Library item: 11599

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Briggs AH.
New methods of analysing cost effectiveness
BMJ 2007 Sep 29; 335:(7621):622
http://www.bmj.com/cgi/content/short/335/7621/622?etoc


Abstract:

Value of information analyses must be integrated into the process of commissioning primary research

Interest in whether health interventions are value for money as well as effective has meant that the term cost effectiveness1 is commonly used (and sometimes misused) in the clinical literature. Consequently, methods for determining cost effectiveness have been refined, especially techniques for synthesising evidence and representing uncertainty in the results of such evaluations. Techniques such as multi-parameter evidence synthesis2 and value of information analysis3 are now routinely integrated into cost effectiveness studies, especially health technology appraisals (HTAs) conducted for the National Institute for Health and Clinical Excellence. But is there real value in the development and application of such techniques, or have these new methods emerged simply as a consequence of involving academics in the process of evaluation?

Colbourn and colleagues present a cost effectiveness and value of information analysis of strategies for preventing group B streptococcal and other bacterial infections in early infancy.4 This is a timely assessment of . . .

a.briggs@clinmed.gla.ac.uk

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909