EDITOR—The editorial by Edworthy shows the dangers of external commentary on what is most useful for developing countries.1 How can we measure the comparative impact of teleconsultation in Uzbekistan or Cambodia with teleconsultation in snowbound northern Canada, telemetry in Norway supporting elderly people at home, or teleradiology avoiding long painful journeys in remote parts of the British Isles? What values do we use—economic, social, quality adjusted life years, consumer feedback, political position, or provider satisfaction?

More importantly, how …