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Evidence in interdisciplinary contexts: the value and ethics of randomised controlled trials

跨学科背景下的证据：随机对照试验的价值和伦理

基本信息

批准号：
ES/L000350/1
负责人：
Linsey McGoey
金额：
$ 3.88万
依托单位：
University of Essex
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2013
资助国家：
英国
起止时间：
2013 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=ES%2FL000350%2F1
关键词：
Evidence interdisciplinary contexts value ethics

项目摘要

Randomised controlled trials (RCTs) are tests that aim to determine the effectiveness of a wide range of things that play an important role in social life, from the safety of new pharmaceutical drugs, to the benefits of economic policies geared at reducing unemployment rates. Government bodies spend considerable financial resources trying to measure the outcomes of the policies that they fund. Despite this investment, it is often hard to determine the benefit of a specific policy, as many environmental, political or social factors external to the policy itself might have contributed to a policy's outcomes. The unique benefit of RCTs is that they use control groups and techniques of randomisation in order to scientifically determine whether or not a policy has produced a specific outcome or not. Since the 1940s, RCTs have revolutionized the way we test and regulate new pharmaceutical drugs. More recently, a second major shift has taken place: academic experts in fields beyond medicine have adopted RCT methodologies in order to evaluate different policies in law, justice services and social welfare. In development economics, there has been a growing use of 'field trials' which use principles of randomisation to appraise the effectiveness of policies in, first example, alleviating poverty, curbing discrimination, or empowering local decision-making. Government practitioners have also embraced RCTs. A 2012 report published by the UK Cabinet Office's Behavioural Insights Team laid out nine steps towards establishing and carrying out more RCTs to inform and formulate domestic policy. It is a similar story at the international level, where standard-setting bodies such as the World Health Organization are becoming increasingly reliant on RCT evidence in order to gauge the effectiveness of different policy approaches to healthcare delivery. Although much research within anthropology, sociology, public health, philosophy and economics has investigated these challenges, to date there has been very little inter-disciplinary discussion between fields. This series of seminars will enable cross-disciplinary engagement with the various economic, political and ethical questions that are raised by the application of RCTs in different fields of knowledge and practice. For example, in medicine and public health, multiple concerns have been raised in relation to the ethics of withholding a needed drug from a control group on trials; whether the results from one study can apply to patients beyond the participants in a trial; and how best to encourage or to legally force private companies to publically disclose all trial results. The growing uptake of RCTs in economics and public policy both reiterates these challenges and introduces new ones. This series would launch the first major investigation into the different disciplinary uses and challenges raised by RCTs in policy-making.Planned outputs include several academic articles, two edited journal collections (with both academic and practitioner contributors); practitioner-focused pieces, an interactive website to promote the seminars and upload papers and outputs, Twitter feed and regular blog.

随机对照试验（RCT）旨在确定在社会生活中发挥重要作用的各种事物的有效性，从新药的安全性到旨在降低失业率的经济政策的好处。政府机构花费大量财政资源试图衡量其资助的政策的成果，尽管有这种投资，但往往很难确定一项具体政策的效益，因为政策本身以外的许多环境、政治或社会因素可能对政策的成果起作用。随机对照试验的独特好处是，它们使用对照组和随机化技术，以便科学地确定一项政策是否产生了特定的结果。自20世纪40年代以来，随机对照试验彻底改变了我们测试和监管新药的方式。最近发生了第二个重大转变：医学以外领域的学术专家采用随机对照试验方法，以评估法律、司法服务和社会福利方面的不同政策。在发展经济学中，越来越多地使用“实地试验”，即使用随机化原则来评估政策的有效性，例如减轻贫困，遏制歧视或赋予地方决策权。政府从业人员也接受RCT。英国内阁办公室行为洞察小组2012年发布的一份报告提出了建立和开展更多随机对照试验以宣传和制定国内政策的九个步骤。在国际层面上也是类似的情况，世界卫生组织等标准制定机构越来越依赖RCT证据来衡量不同医疗保健政策方法的有效性。虽然人类学、社会学、公共卫生、哲学和经济学的许多研究都对这些挑战进行了调查，但迄今为止，各领域之间的跨学科讨论很少。这一系列的研讨会将使跨学科的参与与各种经济，政治和伦理问题所提出的应用随机对照试验在不同的知识和实践领域。例如，在医学和公共卫生领域，人们对以下问题提出了多种关切：在试验中不向对照组提供所需药物的伦理问题;一项研究的结果是否可以适用于试验参与者以外的患者;以及如何最好地鼓励或在法律上迫使私营公司披露所有试验结果。随机对照试验在经济学和公共政策中的日益普及，既重申了这些挑战，又引入了新的挑战。该系列将启动对随机对照试验在决策中的不同学科用途和挑战的首次重大调查，计划产出包括若干学术文章、两个编辑的期刊集（学术界和从业者都有投稿人）、以专家为重点的文章、一个宣传研讨会和上传论文和产出的互动网站、Twitter提要和定期博客。