コストと安全性

1. コストと安全性 残留リスク 社会的許容範囲 安全 安　全　性 納得 How safe is safe enough ? コスト コ　ス　ト

2. 医療政策の課題 • Quality • Access • Cost Qualitative? Quantitative? HSMR?

3. Evangelists and Snails Redux: The Case of Cholesterol Screening Davidoff, Frank MD, Annals of Internal MedicineVol 124(5), 1 March 1996, pp 513-514 • Decision making under uncertainty is hard on everyone. Sackett and Holland suggested that under conditions of uncertainty a divide opens between evangelists and snails along the lines of two entirely different value questions. Evangelists ask “Isn't screening good?’’ whereas snails ask “Isn't there a scientific method for making clinical and health care decisions?”

4. Evangelists and Snails Redux: The Case of Cholesterol Screening Davidoff, Frank MD, Annals of Internal MedicineVol 124(5), 1 March 1996, pp 513-514 • It may be more accurate, however, to view the two positions as flowing from the two opposite ends of a single moral question. Thus, evangelists ask “Isn't it wrong to withhold from patients an intervention with potential benefits and undemonstrated harms?” whereas snails ask “Isn't it wrong to impose on patients an intervention with undemonstrated benefits and potential harms?”--a form of the “glass is half full, glass is half empty'' debate”