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Once Is Not Enough

H. David Banta, MD; Stephen B. Thacker, MD, MSc

JAMA. 1990;264(2):235-240.

Abstract
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.

(JAMA. 1990;264:235-240)

Author Affiliations
From the Netherlands Organization for Applied Scientific Research, The Hague (Dr Banta); and the Epidemiology Program Office, Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Atlanta, Ga (Dr Thacker).

Footnotes
Reprints requests to Epidemiology Program Office, Centers for Disease Control, Atlanta, GA 30333 (Dr Thacker).

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