Are randomised controlled trials (RCTs) always the best way to measure improvement in public services?

Randomised controlled trials (RCTs) are often heralded as the best way to measure improvement in public services – the ‘gold standard’ of evidence.  Two recent articles question this one size fits all approach.

 

Controlled experiments won't tell us which Indigenous health programs are working

Tim Carey, Flinders University

Described as “one of the simplest, most powerful and revolutionary tools of research”, ) has yielded a great deal of important information in the health sciences. It is usually held up as the “gold standard” for gathering medical evidence.

The RCT can tell us which procedure or treatment is more effective under tightly controlled situations. This evidence is useful and important, but we also need to know things like what people want from health services, which treatments are preferred, and why some people stick to treatment regimes and some people don’t.

These issues are particularly relevant to remote Australia and Aboriginal and Torres Strait Islander health, where high levels of illness and early death persist, and where what applies to the tightly controlled conditions of a laboratory rarely translates.

This article was originally published on The Conversation. Read the original article.

This article was originally published on The Conversation. Read the original article.

 

Do the best health care improvement initiatives generate the worst evidence?

With randomised controlled trials held up as the best way to find out if a policy is working or not, Jenny Neuburger looks at a recent hip fracture evaluation that was done differently, and explains that one size does not necessarily fit all.
 
https://www.nuffieldtrust.org.uk/news-item/do-the-best-health-care-improvement-initiatives-generate-the-worst-evidence