In reply: I thank Bece and colleagues and Pitson for engaging constructively with this quality improvement agenda. Bece et al challenge the inclusion of radiotherapy for spinal cord disease in our list of 150 candidate treatments potentially warranting further review under a quality improvement program.1 Pitson calls attention to “loose terminology” in the same example. This latter point, I concede. Precision of language in relation to treatment type and patient indications is essential in this debate.
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- 1. Elshaug AG, Watt AM, Mundy L, Willis CD. Over 150 potentially low-value health care practices: an Australian study. Med J Aust 2012; 197: 556-560. <MJA full text>
- 2. Elshaug AG. Over 150 potentially low-value health care practices: an Australian study. Med J Aust 2013; 198: 85. <MJA full text>
- 3. Elshaug AG, McWilliams JM, Landon BE. The value of low-value lists. JAMA 2013; 309: 775-776.
- 4. Patchell RA, Tibbs PA, Regine WF, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 2005; 366: 643-648.
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