Coping with uncertainty on health decisions: assessing new solutions
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Uncertainty is present in most human decisions. The introduction of health technologies in publicly funded systems is no exception. Sources of uncertainty in this domain come from different grounds, and a variety of means and tools have been developed to cope with unknown parameters and uncertain variables.
Clinical trials were established more formally back in the 1950s and 1960s of the last century in most developed countries as a requirement to reduce uncertainties in general and primarily to guarantee safety and, later, efficacy. The outcomes of such clinical trials allowed us to understand the features of a given agent under certain controlled specific conditions, usually by comparing its medical performance versus a placebo. They have provided basic knowledge for registration, and to fix the price and reimbursement conditions for the majority of new drugs for several decades. However, in order to use this information on drugs, health authorities and physicians had to...