Diffusion of minimally invasive therapy in Europe.

This paper considers the diffusion of the 10 cases presented in this issue. Most of the cases have diffused relatively slowly. This slow diffusion can be explained by a number of factors, including budgetary restraints, financial incentives, physician conservatism, and lack of appropriate training. A consistent thread in the cases is the argument that evidence of effectiveness is not convincing. The article considers whether further diffusion of each innovation can be justified from existing evidence. This information is important for policy purposes. Policies might be developed to encourage or to discourage any potentially important innovation.