Strech Daniel
Institut for Geschichte, Ethik & Philosophie der Medizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover.
Z Evid Fortbild Qual Gesundhwes. 2010;104(3):168-76. doi: 10.1016/j.zefq.2010.03.001.
The existence of value judgements in a science of professional action like medicine is quite uncontroversial. Anything but uncontroversial, though, is the existence of value judgements in Health Technology Assessment (HTA) processes. While value judgements are largely accepted in prioritizing HTA topics the awareness of value judgements in the analysis of evidence in the context of HTA is only rudimentary. The present contribution argues that value judgements do occur in the analysis of evidence in the context of HTA and that they are of practical significance since they have an impact on the final results in a practice relevant manner. I will present value judgements in the determination of threshold values required for establishing the level of significance or for deding on the inclusion of trials. Taking examples from the research on and the discussion of HTA methods I will then show how the blind spot concerning value judgements is currently dealt with and how an appropriate way of dealing with it in the future might look like.
在像医学这样的专业行为科学中存在价值判断是毫无争议的。然而，在卫生技术评估（HTA）过程中存在价值判断却远非毫无争议。虽然在确定HTA主题的优先级时，价值判断在很大程度上是被接受的，但在HTA背景下证据分析中对价值判断的认识却还很初级。本文认为，在HTA背景下的证据分析中确实存在价值判断，而且它们具有实际意义，因为它们以与实践相关的方式影响最终结果。我将阐述在确定显著性水平所需的阈值或决定试验纳入时的价值判断。然后，以HTA方法的研究和讨论为例，我将展示当前是如何处理关于价值判断的盲点的，以及未来可能的适当处理方式会是怎样的。
