Evidence for health decision making — beyond randomised, controlled trials

New England Journal of Medicine

2 August 2017 - A core principle of good public health practice is to base all policy decisions on the highest-quality scientific data, openly and objectively derived.

Determining whether data meet these conditions is difficult; uncertainty can lead to inaction by clinicians and public health decision makers. Although randomised, controlled trials (RCTs) have long been presumed to be the ideal source for data on the effects of treatment, other methods of obtaining evidence for decisive action are receiving increased interest, prompting new approaches to leverage the strengths and overcome the limitations of different data sources.

In this article, I describe the use of RCTs and alternative (and sometimes superior) data sources from the vantage point of public health, illustrate key limitations of RCTs, and suggest ways to improve the use of multiple data sources for health decision making.

Read New England Journal of Medicine review article

Michael Wonder

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Michael Wonder