Technological progress, even when it is real progress, often leads to new problems, difficult choices, and unforeseen dilemmas. The balancing of potential benefits and risks that is part of even routine medical practice is highlighted by the impact of new technologies in medicine.
With this fundamental tension as a likely stimulus, the editors of 89 medical journals from around the world voted to select "Impact of New Technologies in Medicine" as the topic for the 1999 global theme issue.1 This is the third global theme issue selected by medical journals internationally; the first 2 were "Emerging and Reemerging Global Microbial Threats"2 and "Aging."3 A total of 42 medical journals have indicated their participation in the current global theme issue by devoting all or some of their pages to this topic in November 1999 (a list of these journals is available online at http://jama.ama-assn.org/info/links.html). We hope that the simultaneous contributions of so many journals devoted to this topic will spark discussion and sharing of ideas and help lead to better understanding and solutions to some of the problems resulting from the impact of new technologies on health care.
Clearly, technology is not an unequivocal savior. With it often come difficult social, ethical, and economic choices. Many of the articles in this issue of THE JOURNAL highlight these tensions. The potentially beneficial results of fetal surgery to repair myelomeningocele, reported by Bruner et al4 and Sutton et al,5 will make decisions more difficult for parents whose fetuses are afflicted, as they try to weigh the potential benefits and risks of fetal surgery. Likewise, a study by Tamada et al6 of a noninvasive glucose monitoring device and an evaluation by Friedman et al7 of computer-based consultation demonstrate that these innovative diagnostic devices are promising. However, economic realities dictate that such devices no longer will be accepted readily and quickly into common medical practice without determinations of whether they improve patient outcomes and are cost-effective. The multicenter randomized trial conducted by Sloan et al8 of resuscitation with a hemoglobin-based oxygen carrier underscores the importance of carrying out careful evaluations of promising technologies. Commentaries by Perry and Thamer9 and by Eisenberg10 provide thoughtful analyses of the reasons technology assessment is so critical in the current environment.
This global theme issue shows the diversity of the achievements, challenges, and problems that medical technology presents. We hope this cooperative effort among journals can facilitate cooperative efforts among scientists, physicians, and others tackling these perplexing challenges.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Comments are moderated and will appear on the site at the discretion of the Journal of American Medical Association editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
The Rational Clinical Examination Make the Diagnosis: Will This Patient Fall?
The Rational Clinical Examination Original Article: Will This Patient Fall?
All results at JAMAevidence.com >
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.