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79-509: Grattan Institute currently focuses on six key policy areas: Budgets and Government, Disability, Energy and Climate Change, Health, Education, and Economic Policy. Its programs are chosen with the belief that research into these areas, in line with principles of evidence-based policy can make a demonstrable difference to Australia’s public policy. Grattan Institute also makes provision for experts in other fields to work under its umbrella. Grattan Institute began with pressure from senior figures in

158-445: A mean cost of US$ 12 million per RCT. Nevertheless, the return on investment of RCTs may be high, in that the same study projected that the 28 RCTs produced a "net benefit to society at 10-years" of 46 times the cost of the trials program, based on evaluating a quality-adjusted life year as equal to the prevailing mean per capita gross domestic product . The conduct of an RCT takes several years until being published; thus, data

237-500: A choice: either to encourage politicians to adopt more scientific methods or to prompt scientists to employ more political strategies. The ODI suggested that, in the face of limited progress in evidence-based policy, individuals and organizations possessing relevant data should leverage the emotional appeal and narrative power typically associated with politics and advertising to influence decision-makers. Instead of relying solely on tools like cost–benefit analysis and logical frameworks,

316-477: A desire to shift away from ideological decision-making in policy formulation. For instance, a 1999 UK Government white paper, Modernising Government , emphasized the need for policies that "really deal with problems, are forward-looking and shaped by evidence rather than a response to short-term pressures; [and] tackle causes not symptoms." This shift in policy formulation led to an upswing in research and activism advocating for more evidence-based policy-making. As

395-412: A fundamental shift towards policy engagement over academic achievement. This shift implies greater involvement with the policy community, the development of a research agenda centered on policy issues instead of purely academic interests, the acquisition of new skills or the formation of multidisciplinary teams, the establishment of new internal systems and incentives, increased investment in communications,

474-488: A hierarchy; both types of evidence can be effective in different contexts. Policymaking often involves a combination of qualitative and quantitative evidence. Academics provide input to policy beyond the production of content relating to issues addressed via policy through various channels: The Overseas Development Institute (ODI) asserts that research-based evidence can significantly influence policies that have profound impacts on lives. Illustrative examples mentioned in

553-548: A lack of personal equipoise (e.g., a personal belief that an intervention is effective). Finally, Zelen's design , which has been used for some RCTs, randomizes subjects before they provide informed consent, which may be ethical for RCTs of screening and selected therapies, but is likely unethical "for most therapeutic trials." Although subjects almost always provide informed consent for their participation in an RCT, studies since 1982 have documented that RCT subjects may believe that they are certain to receive treatment that

632-428: A method to evaluate the efficacy of ginseng. Many scholars regard evidence-based policy as an evolution from " evidence-based medicine ", where research findings are utilized to support clinical decisions. In this model, evidence is collected through randomized controlled trials (RCTs) which compare a treatment group with a placebo group to measure outcomes. While the earliest published RCTs in medicine date back to

711-524: A prerequisite for publication. One way to classify RCTs is by study design . From most to least common in the healthcare literature, the major categories of RCT study designs are: An analysis of the 616 RCTs indexed in PubMed during December 2006 found that 78% were parallel-group trials, 16% were crossover, 2% were split-body, 2% were cluster, and 2% were factorial. RCTs can be classified as "explanatory" or "pragmatic." Explanatory RCTs test efficacy in

790-522: A procedure for a given study based on its advantages and disadvantages. This is a commonly used and intuitive procedure, similar to "repeated fair coin-tossing." Also known as "complete" or "unrestricted" randomization, it is robust against both selection and accidental biases. However, its main drawback is the possibility of imbalanced group sizes in small RCTs. It is therefore recommended only for RCTs with over 200 subjects. To balance group sizes in smaller RCTs, some form of "restricted" randomization

869-510: A public report issued by the Tariff Board. This report would cover the tariff, industrial, and economic implications. Evidence-based medicine (EBM) is a term that was first introduced by Gordon Guyatt. Nevertheless, examples of EBM can be traced back to the early 1900s. Some contend that the earliest instance of EBM dates back to the 11th century when Ben Cao Tu Jing from the Song dynasty suggested

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948-540: A research setting with highly selected participants and under highly controlled conditions. In contrast, pragmatic RCTs (pRCTs) test effectiveness in everyday practice with relatively unselected participants and under flexible conditions; in this way, pragmatic RCTs can "inform decisions about practice." Another classification of RCTs categorizes them as "superiority trials", "noninferiority trials", and "equivalence trials", which differ in methodology and reporting. Most RCTs are superiority trials, in which one intervention

1027-534: A result, the Campbell Collaboration was established in 1999 as a sibling organization to the Cochrane Collaboration. The Campbell Collaboration undertakes reviews of the most robust evidence, analyzing the impacts of social and educational policies and practices. The Economic and Social Research Council (ESRC) furthered the drive for more evidence-based policymaking by granting £1.3 million to

1106-477: Is a concept in public policy that advocates for policy decisions to be grounded on, or influenced by, rigorously established objective evidence . This concept presents a stark contrast to policymaking predicated on ideology, 'common sense', anecdotes, or personal intuitions. The methodology employed in evidence-based policy often includes comprehensive research methods such as randomized controlled trials (RCT). Good data, analytical skills, and political support to

1185-617: Is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical techniques, medical devices , diagnostic procedures , diets or other medical treatments. Participants who enroll in RCTs differ from one another in known and unknown ways that can influence study outcomes, and yet cannot be directly controlled. By randomly allocating participants among compared treatments, an RCT enables statistical control over these influences. Provided it

1264-412: Is an important part of the scientific method . Reviewers examine the study results for potential problems with design that could lead to unreliable results (for example by creating a systematic bias ), evaluate the study in the context of related studies and other evidence, and evaluate whether the study can be reasonably considered to have proven its conclusions. To underscore the need for peer review and

1343-428: Is available, a placebo may be used in the control group so that participants are blinded to their treatment allocations. This blinding principle is ideally also extended as much as possible to other parties including researchers, technicians, data analysts, and evaluators. Effective blinding experimentally isolates the physiological effects of treatments from various psychological sources of bias . The randomness in

1422-476: Is best for them personally; that is, they do not understand the difference between research and treatment. Further research is necessary to determine the prevalence of and ways to address this " therapeutic misconception ". The RCT method variations may also create cultural effects that have not been well understood. For example, patients with terminal illness may join trials in the hope of being cured, even when treatments are unlikely to be successful. In 2004,

1501-578: Is choosing a randomization procedure to generate an unpredictable sequence of allocations; this may be a simple random assignment of patients to any of the groups at equal probabilities, may be "restricted", or may be "adaptive." A second and more practical issue is allocation concealment , which refers to the stringent precautions taken to ensure that the group assignment of patients are not revealed prior to definitively allocating them to their respective groups. Non-random "systematic" methods of group assignment, such as alternating subjects between one group and

1580-438: Is designed well, conducted properly, and enrolls enough participants, an RCT may achieve sufficient control over these confounding factors to deliver a useful comparison of the treatments studied. An RCT in clinical research typically compares a proposed new treatment against an existing standard of care ; these are then termed the 'experimental' and 'control' treatments, respectively. When no such generally accepted treatment

1659-474: Is hypothesized to be superior to another in a statistically significant way. Some RCTs are noninferiority trials "to determine whether a new treatment is no worse than a reference treatment." Other RCTs are equivalence trials in which the hypothesis is that two interventions are indistinguishable from each other. The advantages of proper randomization in RCTs include: There are two processes involved in randomizing patients to different interventions. First

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1738-437: Is necessary to consider things other than design, such as heterogeneity, population, intervention or comparator. Two other lines of reasoning question RCTs' contribution to scientific knowledge beyond other types of studies: Like all statistical methods, RCTs are subject to both type I ("false positive") and type II ("false negative") statistical errors . Regarding Type I errors, a typical RCT will use 0.05 (i.e., 1 in 20) as

1817-404: Is recommended that allocation concealment methods be included in an RCT's protocol , and that the allocation concealment methods should be reported in detail in a publication of an RCT's results; however, a 2005 study determined that most RCTs have unclear allocation concealment in their protocols, in their publications, or both. On the other hand, a 2008 study of 146 meta-analyses concluded that

1896-410: Is recommended. The major types of restricted randomization used in RCTs are: At least two types of "adaptive" randomization procedures have been used in RCTs, but much less frequently than simple or restricted randomization: "Allocation concealment" (defined as "the procedure for protecting the randomization process so that the treatment to be allocated is not known before the patient is entered into

1975-474: The International Committee of Medical Journal Editors (ICMJE) announced that all trials starting enrolment after July 1, 2005, must be registered prior to consideration for publication in one of the 12 member journals of the committee. However, trial registration may still occur late or not at all. Medical journals have been slow in adapting policies requiring mandatory clinical trial registration as

2054-414: The scientific literature . Not all RCTs are randomized controlled trials (and some of them could never be, as in cases where controls would be impractical or unethical to use). The term randomized controlled clinical trial is an alternative term used in clinical research; however, RCTs are also employed in other research areas, including many of the social sciences . The first reported clinical trial

2133-507: The 1880s, and in education . The earliest experiments comparing treatment and control groups were published by Robert Woodworth and Edward Thorndike in 1901, and by John E. Coover and Frank Angell in 1907. In the early 20th century, randomized experiments appeared in agriculture, due to Jerzy Neyman and Ronald A. Fisher . Fisher's experimental research and his writings popularized randomized experiments. The first published Randomized Controlled Trial in medicine appeared in

2212-518: The 1940s and 1950s, the term 'evidence-based medicine' did not appear in published medical research until 1993. In the same year, the Cochrane Collaboration was established in the UK. This organization works to keep all RCTs up-to-date and provides "Cochrane reviews", which present primary research in human health and health policy. The usage of the keyword EBM has seen a significant increase since

2291-499: The 1948 paper entitled " Streptomycin treatment of pulmonary tuberculosis ", which described a Medical Research Council investigation. One of the authors of that paper was Austin Bradford Hill , who is credited as having conceived the modern RCT. Trial design was further influenced by the large-scale ISIS trials on heart attack treatments that were conducted in the 1980s. By the late 20th century, RCTs were recognized as

2370-550: The 2000s, and the influence of EBM has substantially expanded within the field of medicine. The application of randomized controlled trials in social policy was notably later than in the medical field. Although elements of an evidence-based approach can be traced back as far as the fourteenth century, it was popularized more recently during the tenure of the Blair Government in the United Kingdom. This government expressed

2449-569: The California Department of Corrections, researchers Andrew J. Dick, William Rich, and Tony Waters found that political factors inevitably influenced "evidence-based decisions," which were ostensibly neutral and technocratic. They argue that when policymakers, who have a vested interest in validating previous political judgments, fund evidence, there is a risk of corruption, leading to policy-based evidence making . Evidence-based policy employs various methodologies, but they all commonly share

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2528-1173: The Evidence Network in 1999. Similar to both the Campbell and Cochrane Collaborations, the Evidence Network functions as a hub for evidence-based policy and practice. More recently, the Alliance for Useful Evidence was established, funded by the ESRC, Big Lottery, and Nesta, to advocate for the use of evidence in social policy and practice. The Alliance, operating throughout the UK, promotes the use of high-quality evidence to inform decisions on strategy, policy, and practice through advocacy, research publication, idea sharing, advice, event hosting, and training. The application of evidence-based policy varies among practitioners. For instance, Michael Kremer and Rachel Glennerster , curious about strategies to enhance students' test scores, conducted randomized controlled trials in Kenya. They experimented with new textbooks and flip charts, and smaller class sizes, but they discovered that

2607-506: The ODI recommended identifying key players, crafting compelling narratives, and simplifying complex research data into clear, persuasive stories. Rather than advocating for systemic changes to promote evidence-based policy, the ODI encouraged data holders to actively engage in the political process. Furthermore, the ODI posited that transforming a person who merely 'finds' data into someone who actively 'uses' data within our current system necessitates

2686-706: The UK's Department for International Development's (DFID) new research strategy include a 22% reduction in neonatal mortality in Ghana, achieved by encouraging women to initiate breastfeeding within one hour of childbirth, and a 43% decrease in mortality among HIV-positive children due to the use of a widely accessible antibiotic. Following numerous policy initiatives, the ODI conducted an evaluation of their evidence-based policy efforts. This analysis identified several factors contributing to policy decisions that are only weakly informed by research-based evidence. Policy development processes are complex, seldom linear or logical, thus making

2765-668: The Victorian Premier, Steve Bracks , met with the Federal Treasurer Peter Costello to define the theme for the think tank: Australia as a liberal democracy in a globalised economy . The phrase has since been enshrined in the Constitution of Grattan Institute. Links between the University of Melbourne , Victorian Government and corporate Australia, along with a supportive report from McKinsey & Company , were

2844-534: The Victorian Public Service, academic institutions , and broader business and non-government leaders, who believed that Australian political life lacked a heavyweight independent think tank. Through the course of 2005 this idea was fleshed out by several people in the Victorian Department of Premier and Cabinet, including discussions with a number of Australia’s corporate leaders. At the end of 2005

2923-467: The assessment of intervention effects, which randomized trials primarily aim to provide. In response to such complexities, some policy scholars have moved away from using the term evidence-based policy, adopting alternatives like evidence-informed . This semantic shift allows for continued reflection on the need to elevate the rigor and quality of evidence used, while sidestepping some of the limitations or reductionist notions occasionally associated with

3002-543: The assessor or obtain an objective source of data for evaluation of outcomes." The types of statistical methods used in RCTs depend on the characteristics of the data and include: Regardless of the statistical methods used, important considerations in the analysis of RCT data include: The CONSORT 2010 Statement is "an evidence-based, minimum set of recommendations for reporting RCTs." The CONSORT 2010 checklist contains 25 items (many with sub-items) focusing on "individually randomised, two group, parallel trials" which are

3081-558: The assignment of participants to treatments reduces selection bias and allocation bias, balancing both known and unknown prognostic factors, in the assignment of treatments. Blinding reduces other forms of experimenter and subject biases . A well-blinded RCT is considered the gold standard for clinical trials. Blinded RCTs are commonly used to test the efficacy of medical interventions and may additionally provide information about adverse effects, such as drug reactions . A randomized controlled trial can provide compelling evidence that

3160-429: The assignments in order to reduce the bias. Although the principle of clinical equipoise ("genuine uncertainty within the expert medical community... about the preferred treatment") common to clinical trials has been applied to RCTs, the ethics of RCTs have special considerations. For one, it has been argued that equipoise itself is insufficient to justify RCTs. For another, "collective equipoise" can conflict with

3239-927: The basis for then Victorian Premier Bracks and Treasurer John Brumby in early 2007 to promise significant Victorian Government funding for the idea. Melbourne University was also asked to assist. In April 2008, Commonwealth and Victorian Governments announced matching funding, along with support in kind from the University of Melbourne. Commitments followed soon after from BHP and National Australia Bank . Grattan receives money from its endowment supporters and affiliates, which include Susan McKinnon Foundation, Scanlon Foundation, The Myer Foundation, Origin Energy Foundation, Third Link Growth Fund, Cuffe Family Foundation, Medibank Private , Trawalla Foundation, Wesfarmers , Maddocks, McKinsey & Company, Ashurst , Corrs Chambers Westgarth , Urbis, and Westpac . Grattan Institute

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3318-522: The causes of a causal claim. Furthermore, there have been reports of frontline public servants, such as hospital managers, making decisions that detrimentally affect patient care to meet predetermined targets. This argument was presented by Professor Jerry Muller of the Catholic University of America in his book The Tyranny of Metrics . Randomized controlled trial A randomized controlled trial (or randomized control trial ; RCT )

3397-473: The complexity of policy-making and misconstrue how policy decisions are typically made. Nancy Cartwright and Jeremy Hardie question the emphasis on randomized controlled trials (RCTs), arguing that evidence from RCTs is not always sufficient for making decisions. They suggest that applying experimental evidence to a policy context requires an understanding of the conditions present within the experimental setting and an assertion that these conditions also exist in

3476-439: The danger of overgeneralizing conclusions, two Boston-area medical researchers performed a randomized controlled trial in which they randomly assigned either a parachute or an empty backpack to 23 volunteers who jumped from either a biplane or a helicopter. The study was able to accurately report that parachutes fail to reduce injury compared to empty backpacks. The key context that limited the general applicability of this conclusion

3555-505: The development of their laws. The initiative has created a framework that serves as an example of how to implement evidence-based policy. Pew's five key components of evidence-based policy are: Cost-benefit analysis (CBA) is a method used in evidence-based policy. It is an economic tool used to assess the economic, social, and environmental impacts of policies. The aim is to guide policymakers toward decisions that increase societal welfare. The use of cost-benefit analysis in policy-making

3634-459: The direct application of presented information by policy-makers an unlikely scenario. These factors encompass information gaps, secrecy, the necessity for rapid responses versus slow data availability, political expediency (what is popular), and a lack of interest among policy-makers in making policies more scientifically grounded. When a discrepancy is identified between the scientific process and political process, those seeking to reduce this gap face

3713-648: The following characteristics: The methodology used in evidence-based policy aligns with the cost-benefit framework. It is designed to estimate a net payoff if the policy is implemented. Due to the difficulty in quantifying some effects and outcomes of the policy, the focus is primarily on whether benefits will outweigh costs, rather than assigning specific values. Various types of data can be considered evidence in evidence-based policy making. The scientific method organizes this data into tests to validate or challenge specific beliefs or hypotheses . The outcomes of various tests may hold varying degrees of credibility within

3792-473: The government or policymakers themselves through surveys. Both evidence-based medicine (EBM) and evidence-based public health policy constructions extensively utilize quantitative evidence. Qualitative evidence comprises non-numerical data gathered through methods such as observations, interviews, or focus groups. It is often used to craft compelling narratives to influence decision-makers. The distinction between qualitative and quantitative data does not imply

3871-601: The highest grade." However, a 2001 study published in Journal of the American Medical Association concluded that "discrepancies beyond chance do occur and differences in estimated magnitude of treatment effect are very common" between observational studies and RCTs. According to a 2014 (updated in 2024) Cochrane review, there is little evidence for significant effect differences between observational studies and randomized controlled trials. To evaluate differences it

3950-491: The highest-quality evidence available are: Notable RCTs with unexpected results that contributed to changes in clinical practice include: Many papers discuss the disadvantages of RCTs. Among the most frequently cited drawbacks are: RCTs can be expensive; one study found 28 Phase III RCTs funded by the National Institute of Neurological Disorders and Stroke prior to 2000 with a total cost of US$ 335 million, for

4029-519: The hypothesis being tested. This suggestion contrasted starkly with the prevalent Enlightenment -era attitude that scientific observation can only be objectively valid when undertaken by a well-educated, informed scientist. The first study recorded to have a blinded researcher was published in 1907 by W. H. R. Rivers and H. N. Webber to investigate the effects of caffeine. Randomized experiments first appeared in psychology , where they were introduced by Charles Sanders Peirce and Joseph Jastrow in

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4108-638: The importance of cost-benefit analysis in their executive orders. For example, Clinton's Executive Order 12866 kept the need for cost-benefit analysis but also stressed the importance of flexibility, public involvement, and coordination among agencies. During Obama's administration, Executive Order 13563 further strengthened the role of cost-benefit analysis in regulatory review. It encouraged agencies to consider values that are hard or impossible to quantify, like equity, human dignity, and fairness. The use of cost-benefit analysis in these executive orders highlights its importance in evidence-based policy. By comparing

4187-526: The most common type of RCT. For other RCT study designs, " CONSORT extensions " have been published, some examples are: Two studies published in The New England Journal of Medicine in 2000 found that observational studies and RCTs overall produced similar results. The authors of the 2000 findings questioned the belief that "observational studies should not be used for defining evidence-based medical care" and that RCTs' results are "evidence of

4266-511: The null hypothesis in the respective statistical test . The failure to reject the null hypothesis would imply that the treatment shows no statistically significant effect on the treated in a given test. But as the sample size increases, the same RCT may be able to demonstrate a significant effect of the treatment, even if this effect is small. An RCT may be blinded, (also called "masked") by "procedures that prevent study participants, caregivers, or outcome assessors from knowing which intervention

4345-556: The only intervention that boosted school attendance was treating intestinal worms in children. Their findings led to the establishment of the Deworm the World Initiative, a charity highly rated by GiveWell for its cost-effectiveness . Recent discussions have emerged about the potential conflicts of interest in evidence-based decision-making applied to public policy development. In their analysis of vocational education in prisons run by

4424-525: The other, can cause "limitless contamination possibilities" and can cause a breach of allocation concealment. However empirical evidence that adequate randomization changes outcomes relative to inadequate randomization has been difficult to detect. The treatment allocation is the desired proportion of patients in each treatment arm. An ideal randomization procedure would achieve the following goals: However, no single randomization procedure meets those goals in every circumstance, so researchers must select

4503-452: The potential impacts of different policy options, cost-benefit analysis aids in making policy decisions that are based on empirical evidence and designed to maximize societal benefits. Evidence-based policy has faced several critiques. Paul Cairney, a professor of politics and public policy at the University of Stirling in Scotland, contends that proponents of the approach often underestimate

4582-486: The presentation of research findings; leveraging social networks; and establishing forums to facilitate the connection between evidence and policy outcomes. The Pew Charitable Trusts is a non-governmental organization dedicated to using data, science, and facts to serve the public good. One of its initiatives, the Results First , collaborates with different US states to promote the use of evidence-based policymaking in

4661-490: The probability that the RCT will falsely find two equally effective treatments significantly different. Regarding Type II errors, despite the publication of a 1978 paper noting that the sample sizes of many "negative" RCTs were too small to make definitive conclusions about the negative results, by 2005-2006 a sizeable proportion of RCTs still had inaccurate or incompletely reported sample size calculations. Peer review of results

4740-403: The production of a different range of outputs, and enhanced collaboration within partnerships and networks. The Future Health Systems consortium, based on research undertaken in six countries across Asia and Africa, has identified several key strategies to enhance the incorporation of evidence into policy-making. These strategies include enhancing the technical capacity of policy-makers; refining

4819-446: The results of RCTs with inadequate or unclear allocation concealment tended to be biased toward beneficial effects only if the RCTs' outcomes were subjective as opposed to objective . The number of treatment units (subjects or groups of subjects) assigned to control and treatment groups, affects an RCT's reliability. If the effect of the treatment is small, the number of treatment units in either group may be insufficient for rejecting

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4898-666: The results of the study. Adequate allocation concealment should defeat patients and investigators from discovering treatment allocation once a study is underway and after the study has concluded. Treatment related side-effects or adverse events may be specific enough to reveal allocation to investigators or patients thereby introducing bias or influencing any subjective parameters collected by investigators or requested from subjects. Some standard methods of ensuring allocation concealment include sequentially numbered, opaque, sealed envelopes (SNOSE); sequentially numbered containers; pharmacy controlled randomization; and central randomization. It

4977-439: The results of unblinded RCTs tended to be biased toward beneficial effects only if the RCTs' outcomes were subjective as opposed to objective; for example, in an RCT of treatments for multiple sclerosis , unblinded neurologists (but not the blinded neurologists) felt that the treatments were beneficial. In pragmatic RCTs, although the participants and providers are often unblinded, it is "still desirable and often possible to blind

5056-574: The scientific community, influenced by factors such as the type of blind experiment (blind vs. double-blind), sample size , and replication . Advocates for evidence-based policy strive to align societal needs (as framed within Maslow's Hierarchy of needs ) with outcomes that the scientific method indicates as most probable. Quantitative evidence for policymaking includes numerical data from peer-reviewed journals, public surveillance systems, or individual programs. Quantitative data can also be collected by

5135-460: The specific policy is supported by this evidence according to at least one of the individual's or organisation's preferences in the given policy area. Third, the individual or organisation can provide a sound account for this support by explaining the evidence and preferences that lay the foundation for the claim. The effectiveness of evidence-based policy hinges upon the presence of quality data, proficient analytical skills, and political backing for

5214-567: The standard method for "rational therapeutics" in medicine. As of 2004, more than 150,000 RCTs were in the Cochrane Library . To improve the reporting of RCTs in the medical literature, an international group of scientists and editors published Consolidated Standards of Reporting Trials (CONSORT) Statements in 1996, 2001 and 2010, and these have become widely accepted. Randomization is the process of assigning trial subjects to treatment or control groups using an element of chance to determine

5293-440: The study treatment causes an effect on human health. The terms "RCT" and "randomized trial" are sometimes used synonymously, but the latter term omits mention of controls and can therefore describe studies that compare multiple treatment groups with each other in the absence of a control group. Similarly, the initialism is sometimes expanded as "randomized clinical trial" or "randomized comparative trial", leading to ambiguity in

5372-442: The study") is important in RCTs. In practice, clinical investigators in RCTs often find it difficult to maintain impartiality. Stories abound of investigators holding up sealed envelopes to lights or ransacking offices to determine group assignments in order to dictate the assignment of their next patient. Such practices introduce selection bias and confounders (both of which should be minimized by randomization), possibly distorting

5451-835: The target environment of the proposed intervention. Additionally, they argue that the prioritization of RCTs could lead to the criticism of evidence-based policy being overly focused on narrowly defined 'interventions', which implies surgical actions on one causal factor to influence its effect. The concept of intervention within the evidence-based policy movement aligns with James Woodward 's interventionist theory of causality. However, policy-making also involves other types of decisions, such as institutional reforms and predictive actions. These other forms of evidence-based decision-making do not necessitate evidence of an invariant causal relationship under intervention. Hence, mechanistic evidence and observational studies are often adequate for implementing institutional reforms and actions that do not alter

5530-403: The term evidence-based . Despite these nuances, the phrase "evidence-based policy" is still widely employed, generally signifying a desire for evidence to be used in a rigorous, high-quality, and unbiased manner, while avoiding its misuse for political ends. The shift towards contemporary evidence-based policy is deeply rooted in the broader movement towards evidence-based practice . This shift

5609-404: The terms "single-blind", "double-blind", and "triple-blind"; instead, reports of blinded RCT should discuss "If done, who was blinded after assignment to interventions (for example, participants, care providers, those assessing outcomes) and how." RCTs without blinding are referred to as "unblinded", "open", or (if the intervention is a medication) " open-label ". In 2008 a study concluded that

5688-432: The use of scientific information are typically seen as the crucial elements of an evidence-based approach. An individual or organisation is justified in claiming that a specific policy is evidence-based if, and only if, three conditions are met. First, the individual or organisation possesses comparative evidence about the effects of the specific policy in comparison to the effects of at least one alternative policy. Second,

5767-697: The utilization of scientific information. While proponents of evidence-based policy have identified certain types of evidence, such as scientifically rigorous evaluation studies like randomized controlled trials , as optimal for policymakers to consider, others argue that not all policy-relevant areas are best served by quantitative research. This discrepancy has sparked debates about the types of evidence that should be utilized. For example, policies concerning human rights, public acceptability, or social justice may necessitate different forms of evidence than what randomized trials provide. Furthermore, evaluating policy often demands moral philosophical reasoning in addition to

5846-491: Was conducted by James Lind in 1747 to identify a treatment for scurvy . The first blind experiment was conducted by the French Royal Commission on Animal Magnetism in 1784 to investigate the claims of mesmerism . An early essay advocating the blinding of researchers came from Claude Bernard in the latter half of the 19th century. Bernard recommended that the observer of an experiment should not have knowledge of

5925-408: Was first mandated by President Ronald Reagan's Executive Order 12291 in 1981. This order stated that administrative decisions should use sufficient information regarding the potential impacts of regulation. Maximizing the net benefits to society was a primary focus among the five general requirements of the order. Later presidents, including Bill Clinton and Barack Obama, modified but still emphasized

6004-820: Was incorporated in November 2008, and its founding Chief Executive, John Daley, commenced in January 2009. Upon his departure in July 2020, Danielle Wood (economist) served as Grattan Institute CEO until she was appointed to chair the Productivity Commission in November 2023. Grattan Institute's third Chief Executive, Aruna Sathanapally, commenced in February 2024. Executive (as of August 2024): Board members (as of September 2024) were: Evidence-based policy Evidence-based policy (also known as evidence-based governance )

6083-455: Was largely influenced by the emergence of evidence-based medicine during the 1980s. However, the term 'evidence-based policy' was not adopted in the medical field until the 1990s. In social policy, the term was not employed until the early 2000s. The initial instance of evidence-based policy was manifested in tariff-making in Australia. The legislation necessitated that tariffs be informed by

6162-596: Was received." Unlike allocation concealment, blinding is sometimes inappropriate or impossible to perform in an RCT; for example, if an RCT involves a treatment in which active participation of the patient is necessary (e.g., physical therapy ), participants cannot be blinded to the intervention. Traditionally, blinded RCTs have been classified as "single-blind", "double-blind", or "triple-blind"; however, in 2001 and 2006 two studies showed that these terms have different meanings for different people. The 2010 CONSORT Statement specifies that authors and editors should not use

6241-532: Was that the aircraft were parked on the ground, and participants had only jumped about two feet. RCTs are considered to be the most reliable form of scientific evidence in the hierarchy of evidence that influences healthcare policy and practice because RCTs reduce spurious causality and bias. Results of RCTs may be combined in systematic reviews which are increasingly being used in the conduct of evidence-based practice . Some examples of scientific organizations' considering RCTs or systematic reviews of RCTs to be

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