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Peter D. Jacobson, JD, MPH; C. John Rosenquist, MD
The RAND Corp Santa Monica, Calif

JAMA. 1989;261(10):1442.

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In Reply. —

We thank the authors of the above letters for their comments. In his letter, Dr Anthony raises a question about the percentage of patients who would be considered high risk as defined in our article. The estimate of 15% to 20% was based on our experience as well as estimates from several other hospitals. Certainly, this percentage will vary depending on the patient population and how rigidly the criteria are applied. We agree that additional data about the size of this high-risk group would be helpful.

We are in complete agreement with Dr Anthony's statement that physicians will be faced with more and more difficult decisions as we address the issues of placing limitations on the cost of medical care. We hope our case study of contrast agents will help physicians understand some of the complex medical, economic, legal, and public policy issues.

In their comments about . . . [Full Text PDF of this Article]

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