
Reimbursement for Unproven Therapies: The Case of Thermography-Reply
John H. Ferguson, MD
National Institutes of Health Bethesda, Md
Michael Dubinsky, PhD
Administration for Children and Families Washington, DC
Peter J. Kirsch, JD
Cutler & Stanfield Washington, DC
JAMA. 1993;270(21):2558-2559.
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In Reply.
—In our article we did not wish to single out thermography or thermographers for condemnation. Rather, our study was an attempt to understand how courts arrive at decisions that run counter to accepted medical science. Laetrile, immunoaugmentative therapy, and thermography are examples of technologies in which courts ordered reimbursement for them despite the fact that they had been assessed as being not safe, not effective, or inadequately evaluated. We remain convinced that thermography was and is an appropriate example for our purposes for the following reasons:
The American Medical Association Council on Scientific Affairs1 found that "thermography had not been demonstrated to have any value as a diagnostic test based on information contained in the 1987 Council Report and reviews by other qualified medical groups." They resolved to study the issue further. The American Academy of Orthopedic Surgeons2 adopted a position statement that the "use of
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