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

随机对照试验(RCT)是一种测试，旨在确定在社会生活中发挥重要作用的广泛事物的有效性，从新药的安全性，到旨在降低失业率的经济政策的好处。政府机构花费了大量的财政资源，试图衡量它们资助的政策的结果。尽管进行了这项投资，但往往很难确定具体政策的效益，因为政策本身之外的许多环境、政治或社会因素可能对政策的结果起到了作用。随机对照试验的独特好处是，它们使用控制组和随机化技术，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了随机对照研究方法，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”，它使用随机化原则来评估政策的有效性，首先是减轻贫困、遏制歧视或赋予地方决策权力。政府从业人员也接受了RCT。英国内阁府行为洞察小组2012年发布的一份报告列出了建立和实施更多RCT的九个步骤，以告知和制定国内政策。在国际一级也是如此，世界卫生组织等标准制定机构越来越依赖随机对照试验证据，以衡量医疗保健提供的不同政策方法的有效性。尽管人类学、社会学、公共卫生、哲学和经济学领域的许多研究都对这些挑战进行了研究，但到目前为止，在各个领域之间很少有跨学科的讨论。这一系列研讨会将使人们能够跨学科地探讨在不同的知识和实践领域中应用区域技术所引起的各种经济、政治和伦理问题。例如，在医学和公共卫生领域，人们对以下问题提出了多重关切：在试验中向对照组隐瞒所需药物的道德；一项研究的结果是否适用于试验参与者以外的患者；以及如何最好地鼓励或合法地迫使私营公司公开所有试验结果。在经济和公共政策中越来越多地采用区域技术研究既重申了这些挑战，也带来了新的挑战。这一系列将启动对区域技术小组在决策中的不同学科用途和挑战的首次重大调查。计划的成果包括几篇学术文章、两本编辑的期刊集(有学术和实践者撰稿者)、以实践者为重点的文章、一个用于宣传研讨会和上载论文和成果的互动网站、Twitter订阅源和定期博客。

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.