The Peltzman effect and compensatory markers in medicine.
Unintended consequences of health care interventions are unavoidable. For example, computerized order entry systems, implemented to reduce prescription errors, catalyze novel errors of their own, with providers unexpectedly relying on these systems to provide default dosing information rather than locating appropriate treatment guidelines. We argue that unintended behavioral responses by patients and physicians to health care interventions may explain why certain health care interventions that seem logical and foolproof fail to demonstrate real-world benefits. We argue that compensatory markers which measure behavioral responses in clinical trials should be implemented to better understand why real-world benefits fail to materialize.
Medical Oncology Branch, National Cancer Institute, National Institutes of Health, 10 Center Dr. 10/12N226, Bethesda, MD 20892.
Vinay
V
Prasad
Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115; Tel: 617-432-8322; Massachusetts General Hospital, Boston, MA; and National Bureau of Economic Research, Cambridge, MA.
Anupam B
AB
Jena