Scientific and political issues in evaluating new technology: the case of shock wave lithotripsy

In recent years many methods of surgical care have become available for the treatment of renal stones, but it seems that no single method is the answer to all situations. Although there is insufficient evidence to determine exactly which method is preferable for which type of stone, it is generally conceded that extracorporeal shock wave lithotripsy (ESWL) is a safe and effective technology for the treatment of urolithiasis in the proximal urinary tract. Even though the use of percutaneous lithotripsy has already become widespread, ESWL is being increasingly used in the U.S. today.