The Reproducibility of a Method to Identify the Overuse and Underuse of Medical Procedures

The appropriateness of health procedures has commanded considerable attention recently. 1 – 3 Escalating health care costs and identification of inappropriate care have led to the critical examination of possible overuse and underuse of many medical and surgical procedures and questions as to when or whether they are needed. Central to this examination is the determination of what constitutes appropriate indications for any given procedure. Ideally, this determination would be derived solely from rigorously conducted research that established conclusively the clinical circumstances under which patients benefit from the procedure. Unfortunately, satisfactory data on efficacy and effectiveness are unusual. 4 In fact, several studies . . .