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Secondary prevention fallacy: pitfalls in comparing with primary
J J Caro1, K F Huybrechts, W S Klittich
1jcaro@caroresearch.com
Abstract:
A basic tenet of our culture is the idea that preventing ills is better than curing them. This principle is entrenched in many proverbs and popular admonitions: 'A stitch in time saves nine', 'An ounce of prevention is worth a pound of cure'. These well-worn sayings crisply convey our sense that it is preferable to intervene before a bad event occurs than to wait and try to mitigate it afterwards. Yet, economic analyses have demonstrated that in healthcare this does not hold: 'primary prevention' does not provide as good value-for-money as 'secondary prevention'. Is this reversal of folk wisdom correct? Or, instead, is it a result of faults in the application of the relatively new methodology of cost-effectiveness analyses?
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