This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in JAMA

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Wong and colleagues¹ examined the cost-effectiveness of management strategies for patients with chronic hepatitis C, and the authors concluded that a 12-week initial empirical trial of interferon alfa-2b is a "reasonable management strategy." Given a purported prevalence of some 4 million people in the United States infected with hepatitis C, of whom a significant number may have chronic hepatitis and be candidates for therapy, this is not a trivial recommendation.

Like many readers, I understand the concept and importance of cost-effectiveness analysis but lack the knowledge, time, and energy to carefully analyze the strategies used by authors in performing the analysis. Of particular importance are the various assumptions that need to be made regarding outcomes at different stages. In the article by Wong et al, results of 3 retrospective studies were pooled to obtain the natural history of hepatitis C, and an expert panel of hepatologists . . . [Full Text of this Article]

John B. Wong, MD
New England Medical Center
Tufts University School of Medicine
Boston, Mass

Raymond S. Koff, MD
MetroWest Medical Center
Framingham, Mass

Stephen G. Pauker, MD
New England Medical Center
Tufts University School of Medicine
Boston