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Wednesday, March 30, 2011

Commentary: Sinners, preachers and natural experiments



Two papers in this issue demonstrate the utility of observational methods for evaluating the health effects of policies. 1 , 2 These are helpful as they show the value of such approaches and also identify some of the methodological and other challenges. They are also timely because debates about the need for more evaluations of public health policies and other types of intervention research have moved on significantly in the past 10 years. Macintyre recently noted that commentaries from the 1990's had pointed to the lack of robust evidence to support social and public health policies in the UK. 3 These highlighted the need for more robust and relevant evidence, and noted the lack of evaluations, particularly around health inequalities. This debate about gaps in the evidence base seems to have developed rapidly in recent years into discussions about the methodological implications of such gaps, and the challenges in producing new, reliable evidence. One important piece of methodological guidance to public health researchers in the UK emerged in 2000: this was the first edition of the Medical Research Council's (MRC) Guidance on complex interventions, which focused on the development and evaluation of complex public health interventions, and randomized controlled trials in particular. 4 The … 


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