This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

• Lawrence J. Appel, Johns Hopkins Medical Institutions
• Marc Boutin, National Health Council
• Kay Dickersin, Johns Hopkins Bloomberg School of Public Health
• David Harrington, Harvard School of Public Health
• Peter S. Kim, Stanford University School of Medicine
• Bartha Knoppers, McGill University
• David Korn, Harvard University
• Harlan M. Krumholz, Yale University School of Medicine
• Christine Laine, Annals of Internal Medicine
• Sir Michael Rawlins, Royal Society of Medicine
• Jerome P. Reiter, Duke University
• Donald M. Steinwachs, Johns Hopkins University
• Alan M. Zaslavsky, Harvard Medical School

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Enriqueta C. Bond, QE Philanthropic Advisors, and Stephen E. Fienberg, Carnegie Mellon University. Appointed by the Institute of Medicine and the National Research Council, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.