Portfolio evaluation of health programs: A reply to Sendi et al.

John F.P. Bridges, Darcey D. Terris

Research output: Contribution to journalComment/debatepeer-review


Sendi et al. (Soc. Sci. Med. 57 (2003) 2207) extend previous research on cost-effectiveness analysis to the evaluation of a portfolio of interventions with risky outcomes using a "second best" approach that can identify improvements in efficiency in the allocation of resources. This method, however, cannot be used to directly identify the optimal solution to the resource allocation problem. Theoretically, a stricter adherence to the foundations of portfolio theory would permit direct optimization in portfolio selection, however, when we include uncertainty in our analysis in addition to the traditional concept of risk (which is often mislabelled uncertainty) complexities are introduced that create significant hurdles in the development of practical applications of portfolio theory for health care policy decision making.

Original languageEnglish (US)
Pages (from-to)1849-1851
Number of pages3
JournalSocial Science and Medicine
Issue number10
StatePublished - May 2004


  • Cost-effectiveness analysis
  • Portfolio
  • Uncertainty

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science

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