We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment

It is acknowledged that health technology assessment (HTA) is an inherently value-based activity that makes use of normative reasoning alongside empirical evidence. But the language used to conceptualise and articulate HTA's normative aspects is demonstrably unnuanced, imprecise, and inconsiste...

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Main Authors: Charlton, V, DiStefano, M, Mitchell, P, Morrell, L, Rand, L, Badano, G, Baker, R, Calnan, M, Chalkidou, K, Culyer, A, Howdon, D, Hughes, D, Lomas, J, Max, C, McCabe, C, O’Mahony, JF, Paulden, M, Pemberton-Whiteley, Z, Rid, A, Scuffham, P, Sculpher, M, Shah, K, Weale, A, Wester, G
Format: Journal article
Language:English
Published: Cambridge University Press 2023
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author Charlton, V
DiStefano, M
Mitchell, P
Morrell, L
Rand, L
Badano, G
Baker, R
Calnan, M
Chalkidou, K
Culyer, A
Howdon, D
Hughes, D
Lomas, J
Max, C
McCabe, C
O’Mahony, JF
Paulden, M
Pemberton-Whiteley, Z
Rid, A
Scuffham, P
Sculpher, M
Sculpher, M
Shah, K
Weale, A
Wester, G
author_facet Charlton, V
DiStefano, M
Mitchell, P
Morrell, L
Rand, L
Badano, G
Baker, R
Calnan, M
Chalkidou, K
Culyer, A
Howdon, D
Hughes, D
Lomas, J
Max, C
McCabe, C
O’Mahony, JF
Paulden, M
Pemberton-Whiteley, Z
Rid, A
Scuffham, P
Sculpher, M
Sculpher, M
Shah, K
Weale, A
Wester, G
author_sort Charlton, V
collection OXFORD
description It is acknowledged that health technology assessment (HTA) is an inherently value-based activity that makes use of normative reasoning alongside empirical evidence. But the language used to conceptualise and articulate HTA's normative aspects is demonstrably unnuanced, imprecise, and inconsistently employed, undermining transparency and preventing proper scrutiny of the rationales on which decisions are based. This paper – developed through a cross-disciplinary collaboration of 24 researchers with expertise in healthcare priority-setting – seeks to address this problem by offering a clear definition of key terms and distinguishing between the types of normative commitment invoked during HTA, thus providing a novel conceptual framework for the articulation of reasoning. Through application to a hypothetical case, it is illustrated how this framework can operate as a practical tool through which HTA practitioners and policymakers can enhance the transparency and coherence of their decision-making, while enabling others to hold them more easily to account. The framework is offered as a starting point for further discussion amongst those with a desire to enhance the legitimacy and fairness of HTA by facilitating practical public reasoning, in which decisions are made on behalf of the public, in public view, through a chain of reasoning that withstands ethical scrutiny.
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spelling oxford-uuid:e449526d-4332-451d-aec5-70925bd3396c2024-11-08T09:11:57ZWe need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessmentJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e449526d-4332-451d-aec5-70925bd3396cEnglishSymplectic ElementsCambridge University Press2023Charlton, VDiStefano, MMitchell, PMorrell, LRand, LBadano, GBaker, RCalnan, MChalkidou, KCulyer, AHowdon, DHughes, DLomas, JMax, CMcCabe, CO’Mahony, JFPaulden, MPemberton-Whiteley, ZRid, AScuffham, PSculpher, MSculpher, MShah, KWeale, AWester, GIt is acknowledged that health technology assessment (HTA) is an inherently value-based activity that makes use of normative reasoning alongside empirical evidence. But the language used to conceptualise and articulate HTA's normative aspects is demonstrably unnuanced, imprecise, and inconsistently employed, undermining transparency and preventing proper scrutiny of the rationales on which decisions are based. This paper – developed through a cross-disciplinary collaboration of 24 researchers with expertise in healthcare priority-setting – seeks to address this problem by offering a clear definition of key terms and distinguishing between the types of normative commitment invoked during HTA, thus providing a novel conceptual framework for the articulation of reasoning. Through application to a hypothetical case, it is illustrated how this framework can operate as a practical tool through which HTA practitioners and policymakers can enhance the transparency and coherence of their decision-making, while enabling others to hold them more easily to account. The framework is offered as a starting point for further discussion amongst those with a desire to enhance the legitimacy and fairness of HTA by facilitating practical public reasoning, in which decisions are made on behalf of the public, in public view, through a chain of reasoning that withstands ethical scrutiny.
spellingShingle Charlton, V
DiStefano, M
Mitchell, P
Morrell, L
Rand, L
Badano, G
Baker, R
Calnan, M
Chalkidou, K
Culyer, A
Howdon, D
Hughes, D
Lomas, J
Max, C
McCabe, C
O’Mahony, JF
Paulden, M
Pemberton-Whiteley, Z
Rid, A
Scuffham, P
Sculpher, M
Sculpher, M
Shah, K
Weale, A
Wester, G
We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment
title We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment
title_full We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment
title_fullStr We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment
title_full_unstemmed We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment
title_short We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment
title_sort we need to talk about values a proposed framework for the articulation of normative reasoning in health technology assessment
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