Setting a new standard for how we measure global health

New guidelines for tracking health trends around the world, developed by leaders from influential global health institutions, were announced last week (28 June) in London. These guidelines set a new standard of openness, transparency, and accountability in public health. And they position the field of health measurement at the forefront of science.

But most importantly, they democratize research that seeks to help people live longer and healthier lives.

Some people might be questioning why they should care. The answer is as simple as it is complex: There are potential implications for their health and well-being, as well as their countries' health policies and budgets, and, in turn, mandatory contributions to those budgets in the form of income taxes.

Countless organizations and individuals use, and in some cases, manipulate data for their advantage, whether for prestige or profit, or both. The media are replete with reports on health studies proclaiming how newly discovered drugs could lead to advances for people suffering from Alzheimer's Disease, battling cancer, or managing high blood pressure. The "right" data can lead to "breakthroughs" for pharmaceutical companies, or those researching, manufacturing, and marketing medical devices, naturopathic remedies, and other health-related products and services.

How does one determine the difference between "good science," the result of rigorous research and analysis of data that can be verified for its accuracy, and "bad science," produced from information, the authenticity of which is, at best, suspect, or, at worst, fraudulent?

One of the best ways is the publication of studies in peer-review journals. The new guidelines, known in the scientific community as Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER), were published by PLOS Medicine and The Lancet. The peer-review and editorial process is designed to help ensure thorough and accurate reporting of science, and to avoid over-interpreting results and to clearly acknowledge a study's limitations. These new research and reporting guidelines comprise a useful tool toward those objectives. The 18-point checklist requires disclosure of information regarding data that informs researchers' analyses and their findings. That checklist includes:

• Defining the indicators, populations (including age, sex, and geography), and time periods for which estimates are made;
• Listing funding sources for the work to disclose potential conflicts of interest;
• Describing how data are identified and accessed;
• Providing source information, such as references to individuals, institutions, data collection methods, and timespans of data collection;
• Disclosing ways to access analytic or statistical source codes used to generate estimates; and
• Making data and analyses publicly available for other researchers.

Some medical journals will require authors to use these guidelines to help ensure their data and analyses are appropriately documented. The guidelines also will provide insights into the validity or "weight" of evidence used in analyses. This will increase much-needed transparency in the scientific community, and, by example, potentially raise expectations for transparency and better reporting in all population health studies, regardless of the publication in which they appear.

The working group that created the guidelines included representatives from: PLOS Medicine, the Lancet, the World Health Organization, the London School of Hygiene and Tropical Medicine, the Harvard and Johns Hopkins Schools of Public Health, the University of Oxford, the University of Ottawa, and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle.

The more than 1,700 collaborators from over 120 countries who contribute to the Global Burden of Diseases, Injuries, and Risk Factors enterprise – the largest and most comprehensive effort to date to measure epidemiological levels and trends worldwide – will adhere to GATHER guidelines with each update of the study. Their compliance, and that of other health researchers throughout the world, will lead to more accurate analyses and more informed public health policies. Through better measurement, we will build better health evidence. Better evidence will enable the emergence of new ideas, new best practices, and, ultimately, improvement in the lives of people worldwide.