NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance.
This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education.
This workshop was supported by the Health Care Financing Administration, U.S. Department of Health and Human Services, under Basic Ordering Agreement Contract No. 500–89–0008.
Library of Congress Catalog Card No. 89–64426
International Standard Book Number 0-309-04226-7
Additional copies of this report are available from:
National Academy Press
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Printed in the United States of America
INSTITUTE OF MEDICINE
Division of Health Care Services
HCFA Effectiveness Initiative
Breast Cancer Research Workshop Committee
KENNETH I.SHINE, Chair, Dean,
School of Medicine, University of California, Los Angeles
MARTIN D.ABELOFF, Professor and Associate Director,
Johns Hopkins Oncology Center, Baltimore, Maryland
BARBARA DANOFF FOWBLE, Professor,
Department of Radiologic Oncology, Hospital of the University of Pennsylvania, Philadelphia
SHELDON GREENFIELD, Senior Scientist,
Institute for the Improvenment of Medical Care and Health, New England Medical Center, Boston, Massachusetts
MAUREEN M.HENDERSON, Head,
Cancer Prevention Research Center, Fred Hutchinson Cancer Research Center, Seattle, Washington
VALERIE P.JACKSON, Associate Professor of Radiology,
Department of Radiology, Indiana University School of Medicine, Indianapolis
EMMETT B.KEELER, Senior Mathematician,
Economics Department, The RAND Corporation, Santa Monica, California
LUELLA KLEIN, Professor and Chair,
Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia
|MARY K.KNOBS,
Section on Medical Oncology, Yale Medical Center, New Haven, Connecticut
BARBARA J.MCNEIL, Head,
Department of Health Care Policy, Harvard Medical School, Boston, Massachussettes
JOHN S.MEYER,
Department of Pathology, St. Luke Hospital, Chesterfield, Missouri
MONICA MORROW, Associate Professor of Surgery,
The University of Chicago, Illinois
DAVID G.MURRAY, Professor of Orthopedic Surgery,
Health Services Center, State University of New York, Syracuse
ALAN R.NELSON, Associate,
Memorial Medical Center, Salt Lake City, Utah
J.SANFORD SCHWARTZ, Professor,
General Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia
G.RICHARD SMITH, Associate Professor of Psychiatry,
Department of Psychiatry, University of Arkansas for the Medical Sciences, Little Rock
HAROLD G.SOX, Professor and Chairman,
Department of Medicine, Dartmouth Medical School, Hanover, New Hampshire
WILLIAM C.WOOD, Medical Director,
Cancer Center, Massachusetts General Hospital, Boston
Acknowledgments
The contributions of several members of the Institute of Medicine staff deserve special mention. Among them are H.Donald Tiller, administrative associate, and Theresa Nally, project secretary. Maria Elena Lara was diligent in reviewing workshop materials and earlier drafts of this report, and Kim Heithoff contributed greatly to the smooth logistics of the committee’s homework exercise and the workshop meeting. Richard A.Rettig and Karl D.Yordy provided steady support and leadership throughout the entire project.
The committee is particularly indebted to several of the anonymous reviewers of the draft of this report for comments and suggestions that have been incorporated into the text.
Support for this study was provided by the U.S. Department of Health and Human Services, Health Care Financing Administration. We particularly wish to acknowledge the unflagging assistance and guidance of the government’s project officer, John Spiegel, of the Health Standards and Quality Bureau.
