Education And Debate

Evidence based policy: proceed with careCommentary: research must be taken seriously

BMJ 2001; 323 doi: http://dx.doi.org/10.1136/bmj.323.7307.275 (Published 04 August 2001) Cite this as: BMJ 2001;323:275

Evidence based policy: proceed with care

  1. Nick Black ([email protected]), professor of health services research
  1. Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  2. School of Public Policy, University College London, London
  • Accepted 22 February 2001

The emergence of evidence based medicine in the early 1990s led to some clinicians challenging managers and policymakers to be equally evidence based in their policymaking. This demand was shared by some health policy analysts: “At a time when ministers are arguing that medicine should be evidence-based, is it not reasonable to suggest that this should also apply to health policy? If doctors are expected to base their decisions on the findings of research surely politicians should do the same … the case for evidence-based policymaking is difficult to refute.”1

The need to be seen to be making evidence based decisions has permeated all areas of British public policy. The government has proclaimed the need for evidence based policing, and the 1998 strategic defence review introduced evidence based defence.2 In the health sector, the concept of evidence based policy has gained ground, and a journal has been launched devoted to this challenge (Journal of Evidence Based Health Policy and Management).

Despite some groups using evidence based policy as a fig leaf, it seems difficult to argue with the idea that scientific research should drive policy. However, before accepting the argument we need to understand the implied model of policymaking.

Summary points

Evidence based policy is being encouraged in all areas of public service, including health care

Research currently has little direct influence on health services policy or governance policies

The implicit assumption of a linear relation between research evidence and policy needs to be replaced with a more interactive model

Researchers need a better understanding of the policy process, funding bodies must change their conception of how research influences policy, and policy makers should become more involved in the conceptualisation and conduct of research

Until then, researchers should be cautious about uncritically accepting the notion of evidence based policy

What is the implied model of policymaking?

In …

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