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The ALS Metric is the predominant tool for predicting the cost of ALS systems. Metric goals for the ALS Program are daunting, requiring a threefold increase in the ALS Metric by 2010. Compounding the problem is the slow rate new ALS technologies reach the maturity required for consideration in the ALS Metric and the slow rate at which new configurations are developed. This limits the search space and potentially gives the impression of a stalled research and development program. Without significant increases in the state of the art of ALS technology, the ALS goals involving the Metric may remain elusive. A paper previously presented at his meeting entitled, “Managing to the metric: An approach to optimizing life support costs.” A conclusion of that paper was that the largest contributors to the ALS Metric should be targeted by ALS researchers and management for maximum metric reductions.