RCTs: How compatible are they with policy-making?

Ettelt, S; Mays, N; (2015) RCTs: How compatible are they with policy-making? British Journal of Healthcare Management, 21 (8). pp. 379-382.

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Randomised controlled trials (RCTs) have been promoted as a means of improving policy-making by testing new policies. While testing before full-scale roll-out is commendable, this paper discusses the challenges of using RCTs in contemporary (national) health policy-making in England. There are at least two challenges in particular that are currently underrepresented in the debate: The first arises from the complexity of many policies which are often too diffuse and unclear in focus to allow for the clear distinction between a policy ‘mechanism’ and its context to be drawn that is required for a RCT. The second challenge relates to the timing of RCTs, which tend to take place either too early in the life of a policy to be meaningful or too late to have an effect on policy formulation. We therefore encourage policy-makers and researchers to be clear about the types of uncertainties ‘field experiments’ are meant to address which may be addressed better by other types of knowledge generation.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
URI: http://researchonline.lshtm.ac.uk/id/eprint/2305326


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