ABSTRACT
It has been argued that the best way of describing objectives is in terms of achievement. It is also important that evaluation is carried out without a clear prior view about the answer. It is common for economists to be asked to carry out an economic evaluation study to show that a service is cost-effective. Often attempts are made to avoid even considering options that are considered by clinicians or managers to be unacceptable. While being realistic about what can be achieved in the highly political context of much decision making in health, it is important to try to ensure that a wide range of alternatives is considered in the evaluation exercise.
