Technology Assessment

Abstract

In most internists’ minds, rapid and uncritical adoption of technical “advances” and procedures are associated with surgery. Physicians of a certain age remember nephropexy, uterine suspension, and the Vineberg procedure. More recently, a combination of factors, including large numbers of patients with medically intractable disease, willing and underemployed practitioners, and a belief system that valued doing something over doing nothing, led to performing coronary artery bypass grafting in patients who benefited as well as those who didn't. The ability to sort out the two groups has taken more than a decade. 1 Veterans Administration Coronary Artery Bypass Surgery Cooperative Study Group Eleven-year survival in the Veterans Administration randomized trial of coronary bypass surgery for stable angina, N Engl J Med, 311, 1984, 1333-1339 Google Scholar , 2 CASS Principal Investigators Myocardial infarction and mortality in the coronary artery surgery study (CASS) randomized trial. N Engl J Med. 1984; 310: 750-758 Crossref PubMed Scopus (283) Google Scholar Some of us suspect that lung volume reduction surgery is headed down the same path.