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BY USING TWIGS, MY DESIGN IS MORESTRUCTURALLY SOUND THAN STRAW, YET MORE COST-EFFECTIVE THAN BRICK.
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George A. Diamond, MD
Cost-Effectiveness
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A Moral CalculusPE Ratio = Price / EarningsLP ratio = LDL / HDL
CE Ratio = Bad / Good
Cost-Effectiveness
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CE Ratio = Bad / Good
How much will it cost?
How many will it help?
Cost-Effectiveness
CE Ratio < $ 5 0, 0 0
0
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CE Ratio < $ 5 0, 0 0
0Rank State Per-Capita Income*
1 Connecticut $45,506
28 Texas $30,697
50 Mississippi $24,379
U.S. Average $33,041
* 2004 (www.bea.gov)
Cost-Effectiveness
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Rank Country Per-Capita Income*
5 United States $33,070
18 Canada $20,790
47 Mexico $5,179
World Average $5,003
* 2004 (www.nationmaster.com)
CE Ratio < $ 5 0, 0 0
0
Cost-Effectiveness
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Arbitrary Why not per capita income?
Parochial Why a single value?
Deceptive Why a ratio?
Irrelevant Who cares?
CE Ratio < $ 5 0, 0 0
0
Cost-Effectiveness
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Cost-Effectiveness
Nitroglycerin Stenting
CE Ratio = $100 CE Ratio = $100,000
CE Ratio < $ 5 0, 0 0
0
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The Good . . .
Cost-Effectiveness
How many will it help?
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The Good, the Bad . . .
Cost-Effectiveness
How many will it help?
How much will it cost?
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The Good, the Bad, and the Ugly
How many will it help?
How much will it cost?
How do we pay for it?
Cost-Effectiveness
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Cost-Effectiveness
Treat TestTreat
Target Population 50,000,000 10,000,000
Expected Events 500,000 400,000
Annual Cost $5 Billion $6 Billion
Prevented Events 150,000 120,000
The Good, the Bad, and the Ugly
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Cost-Effectiveness
Treat TestTreat
Target Population 50,000,000 10,000,000
Expected Events 500,000 400,000
Annual Cost $5 Billion $2 Billion
Prevented Events 150,000 120,000
The Good, the Bad, and the Ugly
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Cost-Effectiveness
IS FOR
George A. Diamond, MD(Apologies to) AMBROSE BIERCE
A pseudo-scientific moral calculus
permitting the fabrication of clinically
irrelevant post-hoc justifications for
otherwise indefensible preconceived
notions
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Ghandi Ghoofi
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