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Previous Volume 341:58-60 July 1, 1999 Number 1 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: I am the author of medical policy for one of the largest health care management companies in the United States. I agree with the conclusions of Rosenbaum et al. (Jan. 21 issue)¹ about who should determine when health care is medically necessary, with three important exceptions.

First, "sizable" is a vague and puzzling term to describe the number of studies that would constitute sufficient evidence. Isn't the quality of evidence far more important than the number of papers one can produce? A single, appropriate, randomized clinical trial that proves that a treatment is harmful is enough evidence . . . [Full Text of this Article]

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