Vetting new technologies

Those whose efficacy and safety have not been established will now be registered and evaluated While it is compulsory to evaluate drugs before their widespread use is permitted, other medical interventions are not subject to the same constraints. This has allowed a tidal wave of new health care technologies, which have diffused through health care systems before (or in spite of) proper evaluation to establish safety, effectiveness, or return on investment. This haphazard and uncontrolled adoption of procedures was brought to public attention most recently by the unseemly haste with which laparoscopic surgical techniques were adopted, the associated cases of severe complications,1 and the increased costs.2 The routine use of ultrasound during early pregnancy despite little evidence of benefit3 and the proliferation of unevaluated hip prostheses4 are other examples of the way in which health technologies or their modification can spread without sufficient caution. Highly …