scholarly journals Evidence-based policies, nudge theory and Nancy Cartwright: a search for causal principles

2020 ◽  
pp. 1-20
Author(s):  
ALEJANDRO HORTAL
Keyword(s):  
Public Policy ◽  
Randomized Controlled Trials ◽  
Ethical Issues ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Policy Interventions ◽  
Nancy Cartwright ◽  
Instrumental View

Abstract Nancy Cartwright argues that evidence-based policies should not only rely on randomized controlled trials (RCTs) to test their effectiveness – they should also use horizontal and vertical searches to find support factors and causal principles that help define how those policies work. This paper aims at analyzing Cartwright's epistemology regarding evidence-based policies and their use of RCTs while applying her findings to current research involving nudges as behavioral public policy interventions. Holding a narrowly instrumental view of rationality, nudge theory tends to neglect other expressive components. Policymakers, in their quest for causal principles, should consider the expressive rationality of individuals in their research. This inclusion would not only increase the effectiveness of nudges, but also address some ethical issues related to people's autonomy when targeted by these interventions.

Trends in randomized controlled trials in ENT: a 30-year review

1997 ◽  
Vol 111 (7) ◽  
pp. 611-613 ◽  
Author(s):  
K. W. Ah-See ◽  
N. C. Molony ◽  
A. G. D. Maran
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Randomized Controlled Trials ◽  
Gold Standard ◽  
Controlled Trials ◽  
Evidence Based ◽  
Controlled Clinical Trials ◽  
Medline Search ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled

AbstractThere is a growth in the demand for clinical practice to be evidence based. Recent years have seen a rise in the number of randomized controlled clinical trials (RCTS). Such trials while acknowledged as the gold standard for evidence can be difficult to perform in surgical specialities. We have recently identified a low proportion of RCTS in the otolaryngology literature. Our aim was to identify any trend in the number of published RCTS within the ENT literature over a 30-year period and to identify which areas of our speciality lend themselves to this form of study design. A Medline search of 10 prominent journals published between 1966 and 1995 was performed. Two hundred and ninety-six RCTS were identified. Only five were published before 1980. Two hundred (71 per cent) of RCTS were in the areas of otology and rhinology. An encouraging trend is seen in RCTS within ENT literature.

scholarly journals Breast Cancer Research to Support Evidence-Based Medicine in Nigeria: A Review of the Literature

2021 ◽  
pp. 384-390
Author(s):  
Omolara A. Fatiregun ◽  
Temiloluwa Oluokun ◽  
Nwamaka N. Lasebikan ◽  
Emmanuella Nwachukwu ◽  
Abiola A. Ibraheem ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Research ◽  
Randomized Controlled Trials ◽  
Evidence Based Medicine ◽  
Treatment Guidelines ◽  
Breast Cancer Research ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Based Medicine

PURPOSE Breast cancer is the most common malignancy in women worldwide. In Nigeria, it accounts for 22.7% of all new cancer cases among women. Evidence-based medicine (EBM) entails using the results from healthcare research to enhance the clinical decision-making process and develop evidence-based treatment guidelines. Level 1 and 2 studies, such as randomized controlled trials, meta-analyses, and systematic reviews of randomized controlled trials, yield more robust types of evidence. This study reviewed the levels of evidence of breast cancer publications in Nigeria. METHODS We conducted an electronic literature search of all studies published on breast cancer in Nigeria from January 1961 to August 2019. We reviewed all the articles found under the search term “Breast Cancer in Nigeria” on medical databases. RESULTS Our search identified 2,242 publications. One thousand two hundred fifty duplicates were removed, and 520 were excluded. A total of 472 articles were considered eligible for this review. Most of these articles were case series or reports (30.7%), qualitative studies (15.7%), followed by cross-sectional studies (13.3%), laboratory studies (12.9%), case-control studies (6.1%), case reports (7%), and cohort (5.7%). CONCLUSION Breast cancer research in Nigeria is yet to produce much evidence of the types considered to best support EBM. The scarcity of data hampers the implementation of EBM in Nigeria. Currently, most treatment guidelines are adapted from those developed in other countries, despite genetic differences among populations and different environmental influencing factors.

scholarly journals Some Questions of Ethics in RCTs

2021 ◽  
Author(s):  
Reetika Khera
Keyword(s):  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Ethical Issues ◽  
Human Subjects ◽  
Belmont Report ◽  
Institutional Review Boards ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Institutional Review ◽  
Areas Of Concern

Questions of ethics in Randomized Controlled Trials (RCTs) in development economics need greater attention and a wider perspective. RCTs are meant to be governed by the three principles laid out in the Belmont Report, but often violated them, e.g. when local laws are flouted. In other cases, the framework of the Belmont Report itself has proved inadequate: for instance, when there are unintended outcomes or adverse events for which no-one is held accountable. Primarily using RCTs conducted in India, this paper highlights eight areas of concern. RCTs also have a disproportionate influence on shaping research agendas and on policy. Though ethical issues have been raised, there has been little engagement from the RCT community – a manifestation of its power in the profession. As current safeguards (such as oversight by Institutional Review Boards) have failed to protect human subjects, the concluding section discusses possible ways to resolve these issues.

scholarly journals Clinical Importance of Evidence Based Therapy for Diabetes Type 2

2012 ◽  
Vol 2 (2) ◽  
pp. 21-24
Author(s):  
Mohammad A. Bajubair
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Randomized Controlled Trials ◽  
Oral Treatment ◽  
Ischemic Heart ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Evidence Based Therapy

Objectives: Not all practice guidelines on oral treatment of Type 2 diabetes were consistent with available evidences. Our aim was to explore the necessity of following the new clinical evidences in treatment of diabetes mellitus Type 2 in clinical practice and the availability of randomized controlled trials in literature used. Methods: Cross-sectional interview survey of 20 physicians in the Internal Medicine Departments in Althawra Teaching Hospital, University of Sana'a, Yemen, to understand the drug used in T2DM in regards to the clinically evidenced trials. The three commonly used literatures were studied for the availability of randomized controlled trials s and the systematic reviews. Results: Examples of drugs to be considered in special correlation and contradiction were metformin and thiazolidinediones (rosi-, pioglitazone). Fear of lactic acidosis was seen in 45% of physicians. Ischemic Heart disease and failure represent the commonest cause of glitazones avoidance, especially for rosiglitazone (100% vs. 50% for pioglitazone). Example of drugs used were with no agreements of their benefit are gabapentin (35%) and neurobion (30%) for neuropathy prevention. In the side effect consideration, metformin was still considered dangerous, and B-blockers hesitation in ischemic heart disease prevention. The main source of information used by physicians was Davidson's Medicine, British national formulary and pharmaceutical marketing leaflets. Conclusions: Inconsistency between the tested physicians may be improved by better access and implementation of evidence-based therapy and guidelines in T2DM.

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