The need for adequate assessment of health care technology before accepting it as the standard of care has emerged recently as a primary goal of health services research.1 Many medical techniques nevertheless lack a scientific foundation and do not undergo the same rigorous testing as drugs. The US government and private organizations, like the American College of Obstetricians and Gynecologists, increasingly are setting higher standards for measuring the clinical outcomes and cost-effectiveness of health care technology.
Gynecology, like other surgical specialties, depends on a broad spectrum of standard procedures as well as newer ones.2 Because research has focused less on women's health issues than on those of other groups, unproven technologies have become the subject of much criticism and debate. Until recently, gynecologists based decisions on basic knowledge, training, research, intuition, and expertise. These impressions are now yielding to a new decision-making process