Abstract
Background: Although value issues are increasingly addressed in health technology assessment (HTA) reports, health technology assessment is still seen as a scientific endeavor and
sometimes contrasted with value judgments, which are considered arbitrary and unscientific. This article aims at illustrating how numerous value judgments are at play in the HTA
process, and why it is important to acknowledge and address value judgments.
5
6
7
Methods: A panel of experts involved in HTA, including ethicists, scrutinized the HTA process with regard to implicit value judgments. It was analyzed whether these value judgments
undermine the accountability of HTA results. The final results were obtained after several rounds of deliberation.
8
9
Results: Value judgments are identified before the assessment when identifying and selecting health technologies to assess, and as part of assessment. They are at play in the
selection of studies to include, and in deciding on how to frame, present, summarize or synthesize information in systematic reviews. Also, in economic analysis, value judgments are
ubiquitous. Addressing the ethical, legal, and social issues of a given health technology involves moral, legal, and social value judgments by definition. So do the appraisal and the
decision-making process.
10
11
12
13
Conclusions: HTA by and large is a process of value judgments. However, the preponderance of value judgments does not render HTA biased or flawed. On the contrary they are
basic elements of the HTA process. Acknowledging and explicitly addressing value judgments may improve the accountability of HTA.
Lingua originale | English |
---|---|
pagine (da-a) | 578-585 |
Numero di pagine | 8 |
Rivista | International Journal of Technology Assessment in Health Care |
Volume | 30 |
DOI | |
Stato di pubblicazione | Pubblicato - 2014 |
Keywords
- HTA
- Inglese
- ethics