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Public health evaluation: which designs work, for whom and under what circumstances?

Moore, Laurence Anthony Russell and Moore, Graham ORCID: 2011. Public health evaluation: which designs work, for whom and under what circumstances? Journal of Epidemiology & Community Health 65 (7) , pp. 596-597. 10.1136/jech.2009.093211

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Properly designed and conducted randomised controlled trials (RCTs) represent the most internally valid means of estimating the effectiveness of complex interventions.1 However, RCTs are often dismissed as being unsuitable for the evaluation of public health interventions, in a debate often dominated by arguments based on misunderstandings, misrepresentations and ideological objections. Macintyre2 counters many of these arguments and argues that ‘RCTs are both more possible than many objectors think, and more conclusive about the benefits and cost effectiveness of policies and interventions [than other designs]’. The paper by Bonell and colleagues (see page 582)3 and its companion paper by Cousens and colleagues (see page 576)4 provide welcome contributions to this debate, by seeking to delineate circumstances in which RCTs may not be possible and describing various analytical approaches to compensate for the lack of randomisation in order to derive unbiased estimates of effect. Bonell et al3 identify three key features of RCTs, random allocation, control groups and prospective follow-up, of which only the first is unique to RCTs.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Cardiff Institute of Society and Health (CISHE)
Social Sciences (Includes Criminology and Education)
Subjects: H Social Sciences > H Social Sciences (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Publisher: BMJ Publishing
ISSN: 0143-005x
Last Modified: 07 Jul 2023 01:45

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