IN this issue of Anesthesiology, Sankar et al.1  report the results of a Monte Carlo simulation comparing the cost-effectiveness of using sleep apnea screening for preventing perioperative complications and improving long-term outcomes in patients with obstructive sleep apnea (OSA). Cost-effectiveness analysis quantifies the incremental cost and benefit of selecting a more expensive and more effective healthcare intervention (OSA screening plus polysomnography) compared to a less costly and less effective intervention (no screening). The incremental cost-effectiveness ratio is the ratio of the difference in cost of two interventions divided by the difference in outcome (where outcome is measured in terms of quality-adjusted life-years). The cost-effectiveness ratio can be thought of as the additional cost of achieving 1 yr of perfect life (the quality-adjusted life-year)2  using the more effective intervention. Historically, interventions have been considered cost-effective…