Panel 6: addressing questions of bias, credibility, and quality in health economic evaluations.

Bias, quality, and credibility are long-term research issues addressed by experts in many fields. Like other disciplines, the field of health economics continues to evolve and challenge itself in this regard. Improvements in this field of research necessitate support and adhesion to the highest quality work and integrity, promotion of continuous quality enhancement, and open dialogue. Definition of bias in the field of health economic research refers to a meaning beyond the Stanley and Campbell [1,2] statistical concept (i.e., as a threat to validity). Bias is also an ethical issue dealing with disclosure and conflict of interest. The following definition of bias was proposed by the Task Force on Principles for Economic Analysis of Healthcare Technology in 1995 [3]: “A range of factors that systematically influence the measures undertaken independent of the studied intervention; a tendency, intentional or unintentional, to inappropriately or unfairly favor one or more of the interventions being evaluated.” Resolution of bias, quality, and credibility issues in health economics is complicated by a host of factors, especially the variety of stakeholders and their unique perspectives and information needs. These stakeholders include users of research (managed care organizations, governments, payers, and providers) and the producers of research (government agencies, pharmaceutical firms, payers and providers, academics, consultants, and foundations). The objectives of this panel were to address the issues of bias, quality, and credibility of health economic research from the perspective of both producers and users of these data, with patient care as the underlying concern. The scope of the panel’s deliberation included public dissemination of research data, methods to improve quality, minimize bias, and thus enhance credibility of health economic studies. Methodology issues are elsewhere. The panel anticipates that as advancements are made over time, concerns over bias, quality, and credibility of health economic research will diminish.