The case for reassessment of health care technology. Once is not enough
H. D. Banta and S. B. Thacker
The Netherlands Organization for Applied Scientific Research, The Hague.
Assessment of health care technologies should be an iterative process, not
a single event. In the United States there are an increasing number of
organized attempts at reassessment of technologies by the health industry,
professional societies, and national government agencies, such as the
Medical Necessity Project of Blue Cross/Blue Shield, the Clinical Efficacy
Assessment Project of the American College of Physicians, and the work of
the US Preventive Services Task Force. We examine four clinical
practices--electronic fetal monitoring, episiotomy, electroencephalography,
and hysterectomy--to illustrate the need to continuously reassess existing
technologies and to challenge our current inertia in this critical arena of
health practice.
