Preferences of diabetes patients and physicians: A feasibility study to identify the key indicators for appraisal of health care values

Table 1 Possible sequences for reporting the effects of health care services

	Level of assessment	Level of appraisal
Experimental clinical trials conducted under ideal, but possibly artificial conditions	1^st step Explanatory trial describing possible causal effects of an action under ideal conditions, i.e., describing the efficacy	Not useful
Descriptive studies conducted under day-to-day, real world conditions	2^nd step Pragmatic trial describing the effects of an action under real world conditions, i.e., describing the effectiveness	3^rd step Assessment of individual preferences under real world conditions, i.e. describing the value perceived by an individual

Two assessments under ideal (step 1) and real world conditions (step 2) at the level of assessment are followed by the appraisal of real world results (step 3) from various perspectives. As the available information is growing from step 1 to step 3, it is justified to value health care services the higher the more steps of this sequence were completed. Desired effects which can be detected only under ideal conditions of a clinical trial, but not under real world conditions will be valued lower than desired effects which can be detected also under real world conditions.

ISSN: 1477-7525