An illuminating and timely synthesis of methodological and clinical studies showing how medical costs can be established, how the value of clinical outcomes can be assessed, and how difficult choices can be rationally made. The methodological chapters review the conceptual and practical issues involved in estimating and interpreting health care costs, making health status and utility assessments, and statistically analyzing cost-effectiveness and clinical trials. The clinical chapters apply these methods to the major clinical areas of cardiology-primary prevention of coronary artery disease, acute coronary syndromes, angioplasty vs coronary bypass surgery, CABG vs medicine, congestive heart failure, arrhythmias, and cardiac surgery. Additional chapters consider the use of economic studies for policy purposes and the future of Medicare under a balanced budget in an aging America.