MEASUREMENT: REST OF WORLD
GLOBAL ARITHMETIC BEFORE MEASUREMENT
The findings observed in the United States and United Kingdom are not isolated cases. Large
language model interrogations undertaken across more than 25 countries reveal a remarkable
degree of consistency in the treatment of measurement concepts within HTA knowledge bases.
Countries examined include Australia, New Zealand, Canada and members of the European
Union. Whether the focus is national reimbursement agencies, academic research centres,
journals, professional organizations or educational programs, a common pattern emerges in the
relationship between measurement principles and contemporary HTA practice.
Across jurisdictions, propositions associated with representational measurement, ratio
measurement, dimensional homogeneity and the principle that measurement must precede
arithmetic receive relatively weak endorsement, while utilities, QALYs, reference-case simulation models and cost-effectiveness claims receive strong support. These findings provide a unique perspective
on how measurement is understood within the international HTA community and highlight
the central role played by utility-based and simulation-based approaches in shaping
therapy assessment.
The interrogations also demonstrate that this pattern is not confined to particular countries or
institutions. Similar profiles are observed within national HTA systems, academic research
centres, educational programs and the agencies responsible for therapy assessment in single-
payer health systems. The findings therefore point to a shared international HTA knowledge base
in which measurement concepts occupy a more limited role than numerical modelling and
simulation methodologies. Measurement inversion emerges as a recurring feature across
countries and organizational settings.
Particular attention is given to the European Union, where standardized approaches to therapy
assessment have extended the influence of the reference-case tradition across member states.
This section provides direct links to individual country analyses and institutional reviews,
allowing readers to explore how measurement concepts are represented within HTA systems
around the world and to compare patterns across different national and organizational settings.
ORGANIZATIONS
PSYCHOMETRCS IS NOT MEASUREMENT
THE GLOBAL HEALTH TECHNOLOGY ASSESSMENT MEMEPLEX OF MEASUREMENT FAILURE
EUROPEAN UNION: EUROPEAN UNION: THE EU ORDAINS FALSE MEASUREMENT AS THE BASIS
FOR MEMBER HEALTH TECHNOLOGY ASSESSMENT WITH EUNetHTA AND EU HTA
WORLD HEALTH ORGANIZATION
JOURNALS
UNITED STATES: PHARMACOECONOMICS AND THE ABSENCE OF MEASUREMENT
UNITED STATES: VALUE IN HEALTH AND THE ABSENCE OF MEASUREMENT
AUSTRALIA
AUSTRALIA: THERE ARE ONLY TWO LAWFUL MEASURES FOR THERAPY IMPACT ASSESSMENT
AUSTRALIA: THE END OF THE PBAC REFERENCE CASE – RECONSTRUCTING HTA AROUND MEASUREMENT
AUSTRALIA: WHAT HAPPENS IF NOTHING CHANGES? QUESTIONS FOR THE FUTURE OF HEALTH TECHNOLOGY ASSESSMENT
AUSTRALIA: A NATIONAL CONSENSUS ON THE ABSENCE OF MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT
AUSTRALIA: PHARMACEUTICAL BENEFITS ADVISORY COMMITTEE (PBAC) – DECISIONS WITHOUT MEASUREMENT
AUSTRALIA: DECONSTRUCTING THE EPISTEMIC KNOWLEDGE BASE OF THE AUSTRALIAN AQoL
AUSTRALIA: THE GLOBAL HEALTH TECHNOLOGY ASSESSMENT MEMEPLEX OF MEASUREMENT FAILURE
AUSTRALIA: PSYCHOMETRICS IS NOT MEASUREMENT
RESEARCH CENTERS
AUSTRALIA: THE PBAC AND AUSTRALIAN HTA RESEARCH CENTERS – THE INVISIBILITY OF RASCH MEASUREMENT
AUSTRALIA: THE PBAC AND HTA RESEARCH CENTERS
AUSTRIA
AUSTRIA: NATIONAL DENIAL OF REPRESENTATIONAL MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT
BELGIUM
BELGIUM: THE HEALTH CARE KNOWLEDGE CENTER AND MEASUREMENT AS NONSENSE ON STILTS
CANADA
CANADA: THE HEALTH UTILITIES INDEX: FROM MEASUREMENT INVERSION TO ARITHMETIC CHAOS
CANADA: THE GLOBAL HEALTH TECHNOLOGY ASSESSMENT MEMEPLEX OF MEASUREMENT FAILURE
CANADA: PSYCHOMETRICS IS NOT MEASUREMENT
CANADA: NATIONAL ENDORSEMENT OF MEASUREMENT FAILURE IN HEALTH TECHNOLOGY ASSESSMENT
CANADA: ACADEMIC RESEARCH AND THE ENDORSEMENT OF MEASUREMENT FAILURE IN HEALTH TECHNOLOGY ASSESSMENT
CANADA: CADTH/CDA AND THE ENDORSEMENT OF MEASUREMENT FAILURE
CANADA: QUEBEC AND THE REPRODUCTION OF MEASUREMENT FAILURE IN HEALTH TECHNOLOGY ASSESSMENT
CANADA: HEALTH TECHNOLOGY ASSESSMENT INTERNATIONAL (HTAi) AND THE COMMITMENT TO FALSE MEASUREMENT
CANADA: DECONSTRUCTING THE EPISTEMIC KNOWLEDGE BASE OF THE HUI INSTRUMENTS
CANADA JOURNALS
CANADA: DECONSTRUCTING THE EPISTEMIC KNOWLEDGE BASE OF THE
CANADIAN JOURNAL OF HEALTH TECHNOLOGIES
RESEARCH CENTERS
CANADA: THE ABSENCE OF REPRESENTATIONAL MEASUREMENT AND THE INSTITUTE OF HEALTH ECONOMICS (IHE)
CZECH REPUBLIC
CZECH REPUBLIC: THE NATIONAL ACCEPTANCE OF FALSE MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT
CZECH REPUBLIC: THE APPLICATION OF FALSE MEASUREMENT BY THE STATE INSTITUTE FOR DRUG CONTROL
DENMARK
DENMARK: NATIONAL REJECTION OF REPRESENTATIONAL MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT
DENMARK: OPERATIONALIZING NONSENSE ON QALY STILTS – THE DANISH MEDICINES COUNCIL
DENMARK: OPERATIONALIZING NONSENSE ON QALY STILTS – THE DANISH MEDICINES AGENCY
ESTONIA
ESTONIA: THE NATIONAL ACCEPTANCE OF FALSE MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT
EUROPEAN UNION
EUROPE: THE GLOBAL HEALTH TECHNOLOGY ASSESSMENT MEMEPLEX OF MEASUREMENT FAILURE
EUROPE: PSYCHOMETRICS IS NOT MEASUREMENT
EUROPEAN JOURNAL OF HEALTH ECONOMICS
EUROPEAN JOURNAL OF HEALTH ECONOMICS: INSTITUTIONALIZING FALSE MEASUREMENT
FINLAND
FINLAND: NATIONAL ENDORSEMENT OF MEASUREMENT FAILURE IN HEALTH TECHNOLOGY ASSESSMENT
FINLAND: FINCCHTA ENDORSEMENT OF MEASUREMENT FAILURE IN HEALTH TECHNOLOGY ASSESSMENT
FINLAND: THE EPISTEMIC FAILURE OF THE FINNISH 15D INSTRUMENT
FRANCE
FRANCE: NATIONAL ENDORSEMENT OF MEASUREMENT FAILURE IN HEALTH TECHNOLOGY ASSESSMENT
GERMANY
GERMANY: FROM MEASUREMENT INVERSION TO ADMISSIBLE CLAIMS IN THERAPY IMPACT ASSESSMENT
GERMANY: NATIONAL ENDORSEMENT OF MEASUREMENT FAILURE IN HEALTH TECHNOLOGY ASSESSMENT
GERMANY: CONSTRAINED INSTITUTIONAL ENDORSEMENT OF MEASUREMENT FAILURE BY IQWiG/G-BA
GERMANY: THE HAMBURG CENTRE FOR HEALTH ECONOMICS (HCHE) AND THE ENDORSEMENT OF MEASUREMENT INVERSION
ITALY
ITALY: FROM MEASUREMENT INVERSION TO ADMISSIBLE CLAIMS IN THERAPY IMPACT ASSESSMENT
ITALY: THE CERGAS HTA RESEARCH CENTRE AT BOCCONI UNIVERSITY MILAN ENDORSES FALSE MEASUREMENT
ITALY: MEASUREMENT FAILURE IN NATIONAL HEALTH TECHNOLOGY ASSESSMENT COORDINATION
ITALY: MEASUREMENT FAILURE IN REGIONAL HEALTH TECHNOLOGY ASSESSMENT IMPLEMENTATION
IRELAND
ISRAEL
ISRAEL: NATIONAL INSTITUTIONALIZATION OF FALSE MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT
LATVIA
LATVIA: THE NATIONAL ACCEPTANCE OF FALSE MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT
LITHUANIA
LITHUANIA: THE NATIONAL ACCEPTANCE OF FALSE MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT
NETHERLANDS
NETHERLANDS; THE DUTCH CONTRIBUTION TO NONSENSE ON STILTS IN HEALTH TECHNOLOGY ASSESSMENT
NETHERLANDS: MEASUREMENT FAILURE IN NATIONAL HEALTH TECHNOLOGY ASSESSMENT GUIDELINES
NETHERLANDS: MEASUREMENT FAILURE IN DUTCH ACADEMIC RESEARCH CENTERS FOR HEALTH TECHNOLOGY ASSESSMENT
NEW ZEALAND
NEW ZEALAND: THERE ARE ONLY TWO LAWFUL MEASURES FOR THERAPY IMPACT ASSESSMENT
NEW ZEALAND: NATIONAL ENDORSEMENT OF MEASUREMENT ABSENCE IN HEALTH TECHNOLOGY ASSESSMENT
NEW ZEALAND: THE ABSENCE OF MEASUREMENT IN ACADEMIC RESEARCH GROUPS FOR HEALTH TECHNOLOGY ASSESSMENT
NEW ZEALAND: PHARMAC ENDORSES FALSE MEASUREMENT FOR HEALTH TECHNOLOGY ASSESSMENT
NORWAY
NORWAY: NATIONAL DENIAL OF REPRESENTATIONAL MEASUREMENT
POLAND
POLAND: NATIONAL ENDORSEMENT OF MEASUREMENT FAILURE IN HEALTH TECHNOLOGY ASSESSMENT
POLAND: AOTMiT ENDORSEMENT OF MEASUREMENT FAILURE IN HEALTH TECHNOLOGY ASSESSMENT
PORTUGAL
PORTUGAL: NATIONAL DIFFUSION OF FALSE MEASUREMENT IN HEATH TECHNOLOGY KNOWLEDGE BASE
PORTUGAL: INFARMED AND THE OPERATIONALIZING OF FALSE MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT
SINGAPORE
SINGAPORE: THE ABSENCE OF REPRESENTATIONAL MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT
SPAIN
SPAIN: FROM MEASUREMENT INVERSION TO ADMISSIBLE CLAIMS IN THERAPY IMPACT ASSESSMENT
SPAIN: THE REDETS NATIONAL NETWORK ENDORSES FALSE MEASUREMENT
SPAIN: THE AQuAS CATALAN GOVERNMENT AGENCY ENDORSES FALSE MEASUREMENT FOR HTA
SPAIN: REGIONAL VARIANTS OF MEASUREMENT FAILURE IN HEALTH TECHNOLOGY ASSESSMENT
SWEDEN
SWEDEN: NATIONAL ENDORSEMENT OF MEASUREMENT FAILURE
SWEDEN: TLV REJECTS REPRESENTATIONAL MEASUREMENT
SWITZERLAND
SWITZERLAND: NATIONAL ACCEPTANCE OF FALSE MEASUREMENT IN HEALTH TECHNOLOGY ASSESSMENT