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To the Editor: Dr Groeneveld and colleagues¹ calculated cost-effectiveness ratios of automated external defibrillators (AEDs) on large-capacity aircraft to be less than $50 000 per quality-adjusted life-year (QALY). This calculation agrees with earlier estimates,² and with use of AEDs in airline terminals.³ They also found that the cost per QALY was higher for smaller airplanes than in aircraft with large numbers of passengers.

Groeneveld et al did not estimate the cost-effective ratios of other safety devices on aircraft, such as life jackets and door slides. Do the authors have any data to compare cost-effectiveness ratios of AEDs with those of other accepted safety measures on aircraft? Since large-capacity jet aircraft are safer than smaller aircraft, it is possible that the cost-effectiveness ratios of these measures have a relationship to aircraft size opposite that of AEDs.

Michael F. O'Rourke, MD,DSc
St Vincent's Clinic, UNSW
Sydney, Australia

1. Groeneveld PW, Kwong JL, Liu Y, et al. Cost-effectiveness of automated external defibrillators on airlines. JAMA. 2001;286:1482-1489. FREE FULL TEXT 2. O'Rourke MF, Donaldson E, Geddes JS. An airline cardiac arrest programme. Circulation. 1997;96:2849-2853. FREE FULL TEXT 3. Nichol G, Hallstrom AP, Ornato JP, et al. Potential cost-effectiveness of public access defibrillation in the United States. Circulation. 1998;97:1315-1320. FREE FULL TEXT

In Reply: We agree with Dr . . . [Full Text of this Article]

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RELATED ARTICLE

Cost-effectiveness of Automated External Defibrillators on Airlines
Peter W. Groeneveld, Jeanne L. Kwong, Yueyi Liu, Adam J. Rodriguez, Michael P. Jones, Gillian D. Sanders, and Alan M. Garber
JAMA. 2001;286(12):1482-1489.
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