Letters

Towards investing in health gain Evaluation of interventions is needed

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6943.1568 (Published 11 June 1994) Cite this as: BMJ 1994;308:1568
  1. I G Finlay
  1. Holme Tower Marie Curie Centre, Penarth, South Glamorgan CF64 3YR
  2. Anglia and Oxford Regional Health Authority, Chesterton, Cambridge CB4 1RF
  3. University of Wales College of Medicine. Ely Hospital, Cardiff CF5 5XE.

    EDITOR, - John Gabbay and Andrew Stevens1 have misrepresented the process through which the Welsh Office's protocols for health gain were written. As a member of two of the panels, I disagree that informed consensus was actively “substituted for scientific proof.” The cancers protocol2 was the first one attempted; a technical document was commissioned from Professor Jocelyn Chamberlain to give a starting point; this was sought from outside the principality to ensure an impartial view. For the pain, discomfort, and palliative care protocol,3 the group members wrote a series of technical documents that were critically discussed by the group and externally reviewed by Dr H McQuay (Oxford) and Dr A Diamond (Bristol). The imposition of deadlines is always required to make a group function, but they did not inhibit consultation or discussion.

    Unfortunately, very few medical outcomes have been subjected to rigorous scientific scrutiny. If the …

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