DESCRIPTION (FROM ABSTRACT): Researchers at the Harvard School of Public Health recently developed a database of 228 published cost-utility analyses as a way of both shedding light on society's best opportunities for saving lives and improving human health, and moving the field towards standardization of methods. The proposed research calls for the team to update the current database through 2001, and expand it to include cost-effectiveness analyses that present results in terms of costs per life year gained. The project builds upon our previous efforts in four ways: 1) updating the cost-utility data base through the year 2001; 2) expanding the database to include cost- effectiveness analyses that report results in terms of costs per life-year gained; 3) examining whether key decisions and recommendations about health and medical interventions made by public and private health care organizations reflect cost-effective practices; and 4) putting all the data online for easy access for users. Data will be collected on original cost-effectiveness analyses published through 2001, through an exhaustive search of databases of the literature and other sources. All studies will be reviewed and audited by two trained readers, using a standard data collection form. Information will be collected on all aspects of each article, including descriptive data about the article, journal, and authors; the methods used to develop cost- effectiveness ratios; and the cost-effectiveness ratios provided. This project will provide a unique and enduring tool for researchers and policymakers. Previous work highlighted the tremendous growth in cost-utility analyses over time, the variations in methods used to produce estimates, and the need for improved quality in published studies. The proposed project represents a natural extension of the project which will greatly expand the reach of the database and enhance its usefulness. The database promises to generate a host of new analyses, which will improve our understanding of society=s best opportunities to optimize health benefits in the face of limited resources. Research will shed light on whether decisions made by health care organizations reflect a cost-effective use of society's resources. Finally, all of the data will be accessible on the world wide web for easy access for researchers and policymakers. The web-based data should also understand the needs of different scientists to be understood and policymakers, and bridges to be built across disparate communities.