jay pershad wrote:
> ... THIS DEBATE IS CERTAINLY NOT A $$$ ISSUE. I think it is one of the many
> fascinating aspects of the art of medicine.
I respectfully dissent: To me it is a money issue and there is no art.
It is (or should be, I believe) simply a matter of arithmetic. We
should agree on how much we can afford to spend, and then use the
dollars where we get the greatest return. What art is there to saving
one life (or case of deafness or whatever) at a cost of $X, when that
same $X could have saved two others elsewhere?
The "art" (to me) is an excuse for not having (or else ignoring) the
data. The only logical way to practice is to come up with some cut-off
(sort of like Oregon's plan, but more evidence-based) in terms of
badness prevented per dollar. We need to know the probabilities that
admitting a generally well-appearing patient with a given pleiocytosis
will save bad things, and then simply see if the cost of admission is
below or above the cut-off.
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is: