What does transparency mean?

I am working with a group developing clinical practice guidelines.  Last week the conversation turned to transparency.

What is transparency?

What is meant by transparency?

Do we share everything?

Are we completely open?

Does that make sense while we are trying to make sense of the evidence?

Won’t there be confusion until we know what the guideline will say?

Good questions.

Wikipedia – one of the world’s great examples of transparent collective behaviour – states that “transparency”, as it pertains to behaviour implies openness, communication, and accountability. It is a metaphorical extension of the meaning a “transparent” object is one that can be seen through. Transparent procedures include open meetings, financial disclosure statements, freedom of information legislation, budgetary review, audits, etc.

With regard to research: Scholarly research in any academic discipline may also be labelled as (partly) transparent (or open research) if some or all relevant aspects of the research are open in the sense of open source, open access and open data, thereby facilitating social recognition and accountability of the scholars who did the research and replication by others interested in the matters addressed by it.

With regard to management there emerges the concept of radical transparency:  a management method where nearly all decision making is carried out publicly. All draft documents, all arguments for and against a proposal, the decisions about the decision making process itself, and all final decisions, are made publicly and remain publicly archived.

Three concepts seem to dominate the definitions: openness, ongoing communication, and public accountability.

So what does openness imply?  It seems to evoke attitudes as well as behaviours – without obstruction or concealment, accessible, not secret.  Openness also seems to evoke willingness or readiness to receive – comment, support, aid, and criticism, anything that can help build or align for better results.

Ongoing communication implies a relationship or set of relationships. Good relationships are built on trust, mutual benefit, and reciprocity.  As stated in another post: Communication is a process whereby meaning is defined and shared between living organisms. Communication requires a sender, a message, and an intended recipient, although the receiver need not be present or aware of the sender’s intent to communicate at the time of communication; thus communication can occur across vast distances in time and space. Communication requires that the communicating parties share an area of communicative commonality. The communication process is complete once the receiver has understood the sender.

Public Accountability: accountable to the public?  What do we mean by accounting to the public?  Accountability is the acknowledgment and assumption of responsibility for actions, products, decisions, and policies including the administration, governance, and implementation within the scope of the role or employment position and encompassing the obligation to report, explain and be answerable for resulting consequences.

Perhaps, within the context of guideline production, transparency means responsible and responsiveness to the public – both the specific audience (general practitioners) that “consumes” the guideline as well as the “general public” that will have the guideline applied to their care.  In this responsiveness is a general attitude of seeking input to topic selection, to the results of the assessment of the evidence, and to a continual improving of the products, the communication about those products and how they are used.

Transparency also means that care will be taken to share the methods of producing guidelines as well as the administration and processes used in supporting the production.  The general open behaviour will sometimes bring criticism of specific issues.  But in the long-term, benefits will likely be derived as criticism is an input in continual improvement, creation of efficiencies and innovations in the production of clinical practice guidelines.

Finally, as I have stated before – sharing is the new selfish. Ultimately, transparency begets transparency.  There are more resources applied collectively to guidelines than any one agency or organization can muster. Shared methods lead to shared innovation and better product.  The end result, is improved health outcomes for the public – how responsible is that.

Peter Levesque
Peter LevesquePresident
Institute for Knowledge Mobilization