Education And Debate

Formulate, don't formularise

BMJ 1994; 308 doi: (Published 02 April 1994) Cite this as: BMJ 1994;308:905
  1. C Donaldson

    Too often decisions about the allocation of scarce resources are being formularised (that is, crammed into formulas) rather than formulated (structured on the basis of thought). Those who use the formula of Bochner et al uncritically will be guilty of this. Many users of economic criteria, such as QALY league tables, also fall into this trap. The aim of this commentary is to outline, from an economic perspective, why this is a problem and what can be done about it.

    Formularising hides subjectivity...

    Clinicians and pharmacists are hard people. They are taught to think that subjectivity is “woolly.” This leads to a desire to quantify all relevant considerations in a formula in the belief that this somehow makes things objective. This quantification goes on regardless of whether the elements in the way formula overlap (as they do in the case of Bochner et al) and of whether it is in fact theoretically or practically relevant to combine these elements in the way formulas do. …

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