The need for technology assessment in the reproductive sciences

OBJECTIVE: The problem confronting medicine is the rapid diffusion of technology without prior broad-based critical peer review. Laser therapy is an archetype of this problem. STUDY DESIGN: Guidelines are needed to identify those medical and surgical procedures that are experimental and those that are truly “state-of-the-art” technology. To be cogent these guidelines must cover nonbiomedical issues and include comparisons with alternative modes of therapy. RESULTS: Steps must be taken to augment the number of individuals in our discipline who can provide leadership in technology assessment and health services research. Joint ventures between professional societies and third-party payers are a logical approach to developing and funding technology assessment programs. CONCLUSIONS: These steps should help ensure that clinical decision analysis and operations research develop as a bona fide scientific discipline within the reproductive sciences. Scientific resources developed in this way should help to improve health care by eliminating ineffective procedures and retaining the technologies that are most effective and economic.