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Evidence-Based Public Health: Moving Beyond Randomized Trials

Evidence-Based Public Health: Moving Beyond Randomized Trials Randomized controlled trials (RCTs) are essential for evaluating the efficacy of clinical interventions, where the causal chain between the agent and the outcome is relatively short and simple and where results may be safely extrapolated to other settings. However, causal chains in public health interventions are complex, making RCT results subject to effect modification in different populations. Both the internal and external validity of RCT findings can be greatly enhanced by observational studies using adequacy or plausibility designs. For evaluating large-scale interventions, studies with plausibility designs are often the only feasible option and may provide valid evidence of impact. There is an urgent need to develop evaluation standards and protocols for use in circumstances where RCTs are not appropriate. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Public Health American Public Health Association

Evidence-Based Public Health: Moving Beyond Randomized Trials

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References (27)

Publisher
American Public Health Association
Copyright
Copyright © 2004 by the American Public Health Association
ISSN
0090-0036
eISSN
1541-0048
DOI
10.2105/AJPH.94.3.400
Publisher site
See Article on Publisher Site

Abstract

Randomized controlled trials (RCTs) are essential for evaluating the efficacy of clinical interventions, where the causal chain between the agent and the outcome is relatively short and simple and where results may be safely extrapolated to other settings. However, causal chains in public health interventions are complex, making RCT results subject to effect modification in different populations. Both the internal and external validity of RCT findings can be greatly enhanced by observational studies using adequacy or plausibility designs. For evaluating large-scale interventions, studies with plausibility designs are often the only feasible option and may provide valid evidence of impact. There is an urgent need to develop evaluation standards and protocols for use in circumstances where RCTs are not appropriate.

Journal

American Journal of Public HealthAmerican Public Health Association

Published: Mar 1, 2004

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