In a recent study published in the International Journal of Technology Assessment in Healthcare, researchers question how value judgments affect the conduct of health technology assessments (HTAs).

A study conducted by Professor Bjørn Hofmann’s group during a seminar on methodology in ethics for HTA in Cologne, Germany, in January 2012. Various international experts in the application of this methodology in health technologies met and presented their experiences on how value issues are recognised and managed under the title “Revealing and assessing value judgements in HTA”. The aim was to identify value judgements and their corresponding role in the validity of results in HTA.
The importance of this study is confirmed by the results of Dr. Luis Arellano's group, which found that 90% of the 104 specialists in HTA -who had published between 2005 and 2007- recognized that decisions in health involve value judgments and that, in fact, ethical analysis in HTA is an important process. However, it is still not clear to them how to define the real role of value judgments in this context.

Allied to this factor, the idea of acknowledging such influence of such value judgments, supposedly threatens the basic principle of scientific objectivity of HTA, making it subjective, relative and unreliable; the so-called “Cartesian anxiety”. However, Hofmann et al demonstrate that value judgments are linked to crucial stages of HTA and also emphasize that their explicitness can promote a more transparent and reliable evaluation, as well as lead to more effective and robust decision-making.
They defined value judgments as the evaluation of what would be considered “appropriate.” Applying this concept to HTA, it can be identified that the process involves the use of appropriate scientific methods, aiming for good clinical and morally appropriate results to facilitate socially acceptable decisions at bearable costs. Throughout this process, moral, methodological, legal, social and economic value judgments permeate.
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