JAMA

I was reading a backissue (Feb 7, 2007) of JAMA and came across two interesting things I wanted to mention. "Potential Health and Economic Consequences of Misplaced Priorities" is a commentary that criticizes our allocation of resources in health. It takes a fairly utilitarian view, arguing that "society should pursue interventions in proportion to the ability of those interventions to improve outcomes. All else being equal, a strategy that is more effective than its alternative should receive more [...] attention." It seems to make sense. But Dr. Woolf claims U.S. healthcare fails this paradigm. We spend too much money funding research rather than delivering effective care, preventing diseases, and improving health of minorities and the poor. He cites a study indicating that smoking cessation counseling would save 14 times the quality adjusted life years as breast cancer screening does. On a societal level, these things make a difference. We invest too much on biomedical advances ($28 billion to the NIH in 2006) and too little on infrastructure ($319 million to the Agency for Healthcare Research and Quality). It's an interesting article.

The other thing is the section on "JAMA 100 Years Ago" which reprints articles exactly a century before. This issue's "The Laboratory in Diagnosis" was a really good read. It is searchable, but you need a license to access it online.