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The Value of Low-Value Lists

The Value of Low-Value Lists VIEWPOINT mic heart disease. The main challenge is that interventions Adam G. Elshaug, PhD, MPH proven to be effective for specific clinical populations are often J. Michael McWilliams, MD, PhD inappropriately applied to patients for whom benefit has never Bruce E. Landon, MD, MBA been demonstrated (indication or scope creep). In the United States in particular, extrapolation of evidence is encouraged N INTERNATIONAL GROUNDSWELL OF ACTIVITY IS by financial incentives embedded in physician payment sys- seeking to identify and reduce the use of health temsandcoveragedesignswithlimitedcostsharingforpatients. care services that provide little or no benefit— Just as the development of low-value lists is beset with Awhether through overuse or misuse. There are clinical complexity, so too is their implementation. Al- strong imperatives for identifying such waste: (1) an ethi- though evidence-based assessments of individual health ser- cal imperative to ensure patient safety and thus avoid tests vices often focus on use in specific populations and indica- and treatments that cause harm directly or indirectly with- tions, the presumption of detailed clinical data is often at out providing commensurate benefit; (2) a quality impera- odds with the nature of existing data sources such as ad- tive to measure and reward best practices; http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

The Value of Low-Value Lists

Elshaug, Adam G.; McWilliams, J. Michael; Landon, Bruce E.
JAMA , Volume 309 (8) – Feb 27, 2013
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References (9)

Publisher
American Medical Association
Copyright
Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2013.828
pmid
23443439
Publisher site
See Article on Publisher Site

Abstract

VIEWPOINT mic heart disease. The main challenge is that interventions Adam G. Elshaug, PhD, MPH proven to be effective for specific clinical populations are often J. Michael McWilliams, MD, PhD inappropriately applied to patients for whom benefit has never Bruce E. Landon, MD, MBA been demonstrated (indication or scope creep). In the United States in particular, extrapolation of evidence is encouraged N INTERNATIONAL GROUNDSWELL OF ACTIVITY IS by financial incentives embedded in physician payment sys- seeking to identify and reduce the use of health temsandcoveragedesignswithlimitedcostsharingforpatients. care services that provide little or no benefit— Just as the development of low-value lists is beset with Awhether through overuse or misuse. There are clinical complexity, so too is their implementation. Al- strong imperatives for identifying such waste: (1) an ethi- though evidence-based assessments of individual health ser- cal imperative to ensure patient safety and thus avoid tests vices often focus on use in specific populations and indica- and treatments that cause harm directly or indirectly with- tions, the presumption of detailed clinical data is often at out providing commensurate benefit; (2) a quality impera- odds with the nature of existing data sources such as ad- tive to measure and reward best practices;

Journal

JAMA – American Medical Association

Published: Feb 27, 2013

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