The Reply

Schattner makes many important points in proposing a simple Test Appropriateness Index (TAI) to address the problem of excessive diagnostic studies and treatments. It is well known that a high proportion of medical expenditures occur in the last 6 months of patients’lives. Everyone involved in intensive care unit care knows that a high percentage of these patients will never leave the unit alive (and we know exactly which ones),yet we continue to spend exorbitant amounts of money on their active,not palliative,care—usually including the most costly types of imaging studies.
The American Journal of Medicine

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