BMJ 1995;311:327 (29 July)

Letters

Study's design leaves cost effectiveness and "therapeutic impact" in doubt

EDITOR,--Evaluation of diagnostic technology is generally more difficult than evaluation of therapeutic technology and is often omitted. C M Francis and colleagues' study of the use made by general practitioners of an open access echocardiography service is therefore welcome.1 The descriptive design of the study, however, limits the conclusions that may be drawn from the findings. A comparative study (for example, with a randomised design) would have been more complex but would have yielded additional important information. For example, how would the referring general practitioners have managed these patients in the absence of open access to an echocardiography service? A comparative study would also have permitted a more comprehensive formal economic assessment of the service. We question the authors' conclusion that the study "shows that open access echocardiography is a popular and cost effective service for general practitioners." The effectiveness of the investigation (in terms of health gain for the . . . [Full text of this article]


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Relevant Article

Open access echocardiography in management of heart failure in the community
C M Francis, L Caruana, P Kearney, M Love, G R Sutherland, I R Starkey, T R D Shaw, and J J V McMurray
BMJ 1995 310: 634-636. [Abstract] [Full Text]

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