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What Is a Cost-effectiveness Analysis?-Reply
Marcia J. Chesebro, MD;
W. Douglas Everett, MD, MPH
University of Alabama School of Medicine—Huntsville Program
Arch Fam Med. 1997;6(6):528.
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In reply
We appreciate Dr Harper's in-depth analysis and critique of our work. We agree that there are standards for cost-effectiveness studies and that the book Cost-Effectiveness in Health and Medicine is an excellent reference.1 We did not use the term cost-effectiveness in our title because, according to the Journal of the American Medical Association glossary of methodological terms, cost-effectiveness analysis involves a comparison of alternative programs, services, or interventions. We did not compare alternative strategies and believe our work better fits the definition of cost-benefit analysis.2 The only cost-effectiveness study we are aware of that compares different interventions in the evaluation of squamous intraepithelial lesions (SILs) on Papanicolaou smear results was written by Roland et al.3 They presented a decision model and found little difference in the cost of different treatment strategies. It was not our goal to compare different treatment strategies. We were interested in determining whether colposcopy
. . . [Full Text PDF of this Article]
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