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Variación del Peso durante el Tratamiento para los 24 pacientes

5.2 Discusión sobre la comparación de la dosimetría planificada y administrada al CTV

The International Auditing and Assurance Standards Board (IAASB) has developed a generic assurance standard especially for members of professional accounting bodies when carrying out any assurance engagements other than the audit and review of historical financial information (ISAE 3000, 2008). However, this is now also used by other assurers either as standalone assurance standard or in combination with AA1000AS. ISAE3000 is mostly based on assurance in the financial world (O’Dwyer, Owen, & Unerman, 2011). Hence, ISAE3000 adopts an accountancy approach by emphasising data accuracy (O’Dwyer & Owen, 2005). The New Zealand equivalent of ISAE3000 (ISAE (NZ) 3000) was published in 2014.

Given the list of standards introduced, there are some concerns about selecting the right benchmark, and the relationship between the reporting and assurance standards, and the value of the final assurance statements. The main purpose of sustainability reporting assurance is to increase the reliability and accuracy of the sustainability information disclosed and to be able to provide stakeholders with credible sustainability reports (Gillet, 2012). There are researchers who strongly believe assurance is a necessary and inevitable element of sustainability reporting in terms of building credibility (Deegan et al., 2006; Jones & Solomon, 2010). However, there are doubts around fulfilling the main assurance objectives considering all the differences involved in the assurance process, including having different motivations to engage, following different guidelines and standards, and working with the choice of a large range of sustainability assurers. Hence, as Perego & Kolk (2012) indicated, the existence of different assurance standards and different types of assurers influences the quality of sustainability assurance statements and increases stakeholders concerns about the main role of assurance in adding credibility to the reporting.

2.3.4

Assurance Quality

As in other assuring processes, sustainability assurers should follow the principles of sustainability reporting assurance, as mentioned in the standards. There are two types of guidance in sustainability reporting and its assurance: principles related to the content and principles related to the quality (AccountAbility, 2008a, 2008b; GRI, 2002).

Considering the content principles, assurers need to assess the information included in sustainability reports. They determine whether the information in a sustainability report is material, complete, responsive and if it directly relates to the sustainability performance in order to apply content principles (AccountAbility, 2003; GRI, 2002):

Materiality - The assurers should examine the sustainability report to assess the materiality of the

information for the reporting organisation and the reporting organisations’ stakeholders. Information is material if its omission or misrepresentation in a report could influence the decision of stakeholders.

Completeness - The assurers should evaluate the sustainability report to assess whether it is complete

and accurate enough to identify and understand the organisation’s performance from its stakeholders’ viewpoints.

Responsiveness - The assurers should assess that the reporting organisation has responded to

stakeholders’ concerns and interests, policies and relevant standards, and whether the disclosed sustainability information reflects these responses adequately.

Sustainability Context - The assurers should evaluate the context of the sustainability report to assess

whether the focus of the report is the sustainability performance of the organisation.

In terms of quality principles, assurers need to assess the quality of the reported information. The quality of the information enables stakeholders to make informed decisions and take the appropriate action (AccountAbility, 2003; GRI, 2002):These principles, below, are similar to the qualitative characteristics of financial information:

Balance - The assurers should check that the organisation has provided an unbiased picture of its

sustainability performance. Sustainability reports should reflect both the positive and negative aspects of an organisation’s performance.

Comparability - The assurers should evaluate that the sustainability report is comparable with the last

sustainability report and with other organisations’ sustainability reports. Hence, organisations should consider consistency in their reports over time.

Accuracy - The assurers should examine if the sustainability report is sufficiently accurate and detailed

for stakeholders to assess the organisation’s performance.

Timeliness - The assurers should assess the usefulness of the sustainability report based on the time

that it is available for stakeholders. Releasing information in an efficient timeframe enables stakeholders to integrate the information into their decision-making.

Clarity - The assurers should monitor the sustainability report to assess that it is understandable,

accessible and usable to the range of stakeholders, as the level of aggregation of the information can influence the clarity of a report.

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Reliability - The assurers should evaluate the sustainability information to assess that it is gathered,

recorded, analysed and disclosed in a way that can establish the quality and materiality of the information.

To be able to achieve the main target of assurance, organisations should follow these principles when preparing sustainability reports, and assurers should assess them when conducting sustainability reporting assurance. However, there are still no mandatory standards for sustainability reporting and sustainability reporting assurance in many parts of the world.

Ball et al. (2000) started questioning the role of sustainability assurance in promoting organisational transparency by conducting research on a sample of companies short listed for the Association of Chartered Certified Accountant’s Environmental Reporting Awards (ACCA ERAS). The results of their content analysis revealed that assurance providers’ works are significantly different due to not having a robust methodology and focusing only on the management control systems instead of the performance. Therefore, there are some difficulties in fulfilling the main assurance objective, which is about increasing transparency and accountability. Later, O’Dwyer & Owen (2005) directly assessed the quality of sustainability reporting assurance statements for the first time, using their own quality measure. The quality of sustainability reporting assurance statements was evaluated against the recommended criteria mentioned in sustainability reporting and assurance guidelines and standards, as issued by GRI, AccountAbility, IAASB and the Fédération des Experts Comptables Européens (FEE). O’Dwyer & Owen (2005) selected assurance statements related to the sustainability reports short- listed for the 2002 ACCA-UK and European Sustainability Reporting Awards. They discovered improvements in terms of the assurance undertaken and also identified a greater focus on sustainability performance, while there were still some concerns about the low level of stakeholder engagement that resulted in low quality, poor transparency and a lack of credibility. That study discovered an association between the quality of assurance and the type of assurers. The consultants’ approach provided a higher level of assurance since their statements were mostly focused on completeness, fairness and overall balance, while the accountants’ opinions were mostly around data accuracy. (Perego & Kolk (2012) followed the O’Dwyer & Owen's (2005) approach to assess the quality of sustainability reporting assurance statements among the Fortune Global 250 companies over ten years. Their cross-country study claimed that the quality of assurance statement was highly associated with the type of assurer. Several other studies (CPA Australia, 2004; Hodge et al., 2009; Mock et al., 2007; Moroney et al., 2012; Perego, 2009; Pflugrath et al., 2011; Seguí-Mas et al., 2015; Simnett et al., 2009; Zorio, García-Benau, & Sierra, 2013) supported the quality of assurance statements and, as a result, the credibility of sustainability reports, was associated with the type of assurer selected by the reporting organisation.

Some studies, such as those by Perego & Kolk (2012), Perego (2009) Pflugrath et al. (2011) and Simnett, Nugent, & Huggins (2009), found a higher quality in the assurance statements prepared by accounting specialists. Accounting specialists who are actively working in this area of assurance are the Big 4 accounting firms. These firms are able to provide a high-quality service due to having a capacity to hire knowledgeable and experienced personnel, invest in accurate assurance and control mechanisms and have the incentive to protect their reputations (Perego, 2009; Simnett, Nugent, et al., 2009). On the other hand, O’Dwyer & Owen (2005) revealed that assurance statements provided by consultants added more value in comparison to the ones prepared by accountants. Similarly, the findings from a recent study of the top 300 cooperatives around the world stated that although accountants were the majority of sustainability assurers, the quality of assurance statements provided by consultants was of a significantly higher standard (Seguí-Mas et al., 2015). Meanwhile, there is some evidence indicating that the assurer’s type does not affect the quality and the level of reliance that users place on different assurance statements (Ackers, 2015).

Apart from the assurers, there is some evidence that assurance standards also influence the quality of assurance statements (Deegan et al., 2006; Perego & Kolk, 2012; Peters & Romi, 2015). The report prepared by AccountAbility and KPMG indicated that the use of different assurance standards resulted in very different assurance statements. For example, using ISAE3000 resulted in statements that covered much about weaknesses and limitations of the organisation’s reporting, while following AA1000AS as the assurance standard resulted in statements, which not only focused on the weaknesses and strengths of the sustainability reports, but also commented on related sustainability systems and addressed stakeholder’s concerns (Iansen-Rogers & Oelschlaegel, 2005).

Based on the findings of Australian and cross-country studies – Perego & Kolk, (2012) and Choon-Yin & Tiong (2015) – considering the average quality of assurance statements, there are still some areas that need improvement due to the existence of a quality gap. They indicated that there was a gap between the highest quality according to reporting criteria and assurance standards, and the current quality of sustainability reporting assurance statements. This identified gap motivated this research to undertake an examination about the quality of assurance statements through answering research question three and contribute to the knowledge by searching for improvements through designing research question four stated in section 1.2.

As explained above, previous studies have resulted in much uncertainty and many contradictions about the motivations for, and barriers to, assurance engagement and its benefits; different assurers and their differences; and the quality of assurance statements. The next section provides some insights about similar areas, particularly in New Zealand.

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2.4

Sustainability Reporting and Sustainability Reporting Assurance in