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Perry A. Lambird, MD, MPA
Medical Arts Laboratory Oklahoma City, Okla

JAMA. 1991;265(15):1950.

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

To the Editor. —

The treacherous nature and potential pitfalls of "cost-effectiveness analysis" are illustrated in part in the recent article by Schulman et al.¹

Costs are notoriously difficult to identify and define. Misidentifying costs can warp results. The authors based laboratory costs on the workload recording manual of The College of American Pathologists² (which they referred to as a "relative value scale"), adjusted by Maryland hospital "costs per work unit."

The College of American Pathologists' workload method is not a relative value scale. It is solely a standardized method of evaluating the time required of medical technologists to perform a test. It cannot accurately be converted into total costs, since all of the other laboratory costs are not linearly correlated with personnel costs. The manual cited was even 8 years out of date.

For the purpose of assessing costs of lipid-lowering regimens, independent laboratory costs are more . . . [Full Text PDF of this Article]

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