32k NEKOL S/S

STANFORD UNIVERSITY MEDICAL CENTER

STANFORD, CALIFORNIA 94305 e (415) 321-1200

 

 

STANFORD UNIVERSITY SCHOOL OF MEDICINE
Department of Genetics

OCT 22 179

Dear Dr. Morgan:

I am gratified to note the actions recorded in the article
in the Wall St. Journel. If there is se formsl procedure for
submitting comments on the standerds, I would sppreciate being
apprised of the correct channel.

May I also ask you for references to whatever cost-benefit
analyses may have been made to suggest a rational approach at
calculseting the Pareto-optimum for the investment in reducing
X-ray exposure? Pert of this exercise would also include an
estimate of the existing cost of radiology, per rad, and some
breakdown by different functions.

I attach for your mnterest some crude calculations of my own
which may be relevant to a cost-benefit analysis. My estimete
of $100 as the present value of the integrated genetic-health
cost per rad of exposure (gonadal) will drew fire from both sides
of the present controversy; but I do not see how it can easily
be wrong by much more then s factor of 10. At the same time
it is, or should be, consistent with the good practice of radio-
logy, in terms of the expected value to the patient; and it is
not that far off what he is likely to be chargedi for the service.
(I am of course speaking of diagnostic work). At least these
are some reasonable suppositions, about which I have asked you
for some supporting data in my previous paragraph.

But then there must still remain an enormous latitude to jus-
tify adding $1000 to the price of a machine thet surely must de-
liver many kilorads during its useful lifetime, when ss you sug-
gest the improvement could give a 1/3 reduction in needless ex+
posure! The kind of number I find elusive is just what the cost
per rad-reduced will be.

Please let me know if I can be of any service in this metter.

Yours sincerely,

Joshus Lederberg
Professor of Genetics

LT. J. P. KENNEDY, JR. LABORATORIES FOR MOLECULAR MEDICINE, DEDICATED TO RESEARCH IN MENTAL RETARDATION
MOLECULAR BIOLOGY HEREDITY NEUROBIOLOGY DEVELOPMENTAL MEDICINE