I've actually used AHRQ's software to create Inpatient Quality Indicator
reports.  I can confirm pretty much what we already know; it is inefficient.
Running on about 1.8 - 2 million cases, it would take just about a whole day
to run the entire process from start to finish.  That isn't all processing
time and includes some time for the analyst to check results between
substeps, but I still knew that my day was full when I was working on IQI
reports.



To be fair though, there are a lot of other factors (beside efficiency
considerations) that go into AHRQ's program design.  First, there are a lot
of changes to that software every year.  In some cases it is easier and less
error prone to hardcode a few points in the data so that it is blatantly
obvious what to change next year should another analyst need to do so.  Second,
the organizations that use this software often require transparency and may
not have high level programmers on staff.  Writing code so that it is
accessible, editable, and interpretable by intermediate level programmers or
analysts is a plus.  Third, given that IQI reports are often produced on a
yearly basis, there's no real need to sacrifice clarity, etc. for efficiency
- you're only doing this process once a year.



There are other points that could be made, but the main idea is I don't
think it's fair to hold this software up, out of context, as an example of
SAS's (or even AHRQs) inefficiencies.  I agree that SAS syntax is nowhere
near as elegant or as powerful as R from a programming standpoint, that's
why after 7 years of using SAS I switched to R.  But comparing the two at
that level is like a racing a Ferrari and a Bentley to see which is the
better car.

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