Scientists and clinicians have to be on the qui VIVE: benefit, outcome, value and utility in health care as a challenge

Aim

Health care is no longer a national topic as the results of health care research as well as health care services are shared across countries and continents. The common feature in almost any of these countries is the perceived limitation of health care resources and the discussions about health care expenditures which strongly depend on the definition of health care values.

Hygienization of terms

Identical terms should be used with the same commonly accepted meanings.

Different perspectives–different values

Health care values from a US, UK and German perspective are compared and the influence of the perspectives on practical health care decisions are discussed.

The sequence of value information validity evidence (VIVE)

Seven steps are presented which can capture the value of health care from the perspectives of different players.

Conclusion

Two reciprocal perspectives explain the differences. The individual perspective, which is used by patients and doctors, considers consequences per costs, while a general perspective, which is used by economists and politicians, considers costs per consequences. The conclusions derived from these two perspectives are different and depend on values, not directly on evidence. Nevertheless, evidence is essential to coin our values. Therefore, it is essential first to define the problem which has to be solved, and subsequently to select the methods that help to find and to appraise the found evidence. The appraised evidence will coin our values which finally are the basis for solving the problems.