Resumen

CAMPILLO-ARTERO, Carlos. Publication bias, value of information and their effects on health policy decision making. Rev Cubana Salud Pública [online]. 2012, vol.38, suppl.5, pp. 714-724. ISSN 0864-3466.

Inadequate information used to support decision making in public health and health services is remarkable. The objective of this paper was to provide a synthesis of some of its causes and effects. Many studies show that two of the main limitations that affect the decision making are low quality and inadequacy of available scientific information. The latter consists of deficient reporting of study results. It encompasses manipulation of primary and secondary variables, abuse of surrogate and composite variables, intentional omission of outcome reporting and publication biases. The lower the value of available information for decision making, the higher the opportunity cost of decisions. This cost can be translated into health benefits lost due to delayed adoption of potentially effective and efficient interventions and medical technologies, or adverse health effects and inefficiencies due to their early diffusion in the absence of sufficient scientific evidence of their efficacy, effectiveness or efficiency. Main solutions put forward are regulatory science measures, public registry of interventions in public health and clinical trials, use of estimation and Bayesian statistics instead of hypothesis testing, and declaration of conflicts of interests. Policy makers, public health professionals and clinicians should neither spare effort nor further delay the implementation and consolidation of these long known measures intended to minimize those limitations. Legitimacy and the level of scientific evidence of decision making will eventually depend on the effectiveness of those solutions.

Palabras clave : decision making; health policy; value of information; biases.

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