Experimentation and social interventions: a forgotten but important history

doi:10.1136/bmj.317.7167.1239

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Ann Oakley, professor (a.oakley@ioe.ac.uk)

Social Science Research Unit, University of London Institute of Education, London WC1H 0NS

Accepted 1 October 1998

The research design of the randomised controlled trial is primarily associated today with medicine. It tends either to be ignored or regarded with suspicion by many in such disciplines as health promotion, public policy, social welfare, criminal justice, and education. However, all professional interventions in people's lives are subject to essentially the same questions about acceptability and effectiveness. As the social reformers Sidney and Beatrice Webb pointed out in 1932, there is far more experimentation going on in “the world sociological laboratory in which we all live” than in any other kind of laboratory, but most of this social experimentation is “wrapped in secrecy” and thus yields “nothing to science.”1

Summary points

Many social scientists argue that randomised controlled trials are inappropriate for evaluating social interventions, but they ignore a considerable history, mainly in the United States, of the use of randomised controlled trials to assess different approaches to public policy and health promotion

A tradition of experimental sociology was well established by the 1930s, built on the early use of controlled experiments in psychology and education

From the early 1960s to early 1980s randomised experiments were considered the optimal design for evaluating public policy interventions in the United States, and major evaluations using this design were carried out

This approach became less popular as policy makers reacted negatively to evidence of “near zero” effects

Lessons to be learnt about implementing randomised controlled trials in real life settings include the difficulty of assessing complex multi-level interventions and the challenge of integrating qualitative data

The Webbs argued for a more “scientific” social policy, with social scientists being trained in experimental methods and evaluations of social interventions being carried out by independent investigators. They were apparently unaware that a strong tradition in experimental sociology had already been established, mainly in the United States. …