Effectiveness in Health Care

ALTHOUGH modern medicine provides great benefits to large numbers of people, medical professionals and clinical researchers have expressed concern about the effectiveness and appropriateness of many current and emerging medical practices. For example, the evidence substantiating the effectiveness of many such practices is frequently questionable and in many instances entirely lacking.1 Research on medical interventions is often poorly designed and methodologically flawed.2 , 3 Many physicians lack the skills to interpret and critically evaluate medical literature,4 and they approach the same clinical problem with different theoretical assumptions, contributing to wide variations in practice patterns.5 , 6 Furthermore, physicians have difficulty incorporating information about probabilities . . .