Abstract
Today's medical technology is more advanced, more effective, and in many cases, more costly than ever before. Furthermore there is an ever increasing demand for high technology diagnostic and therapeutic health care facilities and their availability may come into conflict with medical necessity, social justice and cost effectiveness. There is increasing pressure on health care resources that is driving more explicit and public decisions regarding the best use of these resources. The complexity of modern technology and its high marginal cost suggest to us that testimonial reviews of new technologies are no longer sufficient. Current trends in health care decision making favour a transition from a rationale based primarily on resources and opinion to a rationale derived from research.
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