ABSTRACT
This chapter examines one particular research project, and considers the same issues in respect of Alzheimer’s Disease. J. Herman notes the importance of differences between trial and routine clinical practice, and warns of the placebo effect, which may be present even for active treatments. In practice, even given quality-adjusted-life-year (QALY) hrqol data, surgeons have to determine survival impacts by interpreting the results of a trial or trials carried out elsewhere. Only in this way can they assess what survival would be in their specific locality, in order to reach a conclusion about the value of treatments in terms of QALYs. The chapter also considers how a basis for resource allocation between sectors might be developed, if Mean Expected QALY Indicator values were available for all the sectors of a health service, managed on a regional basis.
