RCTs in Economics

Marc Bellemare with interesting thoughts on the positives and negatives of using RCTs in development economics. I am chewing on what these observations mean for U.S. health policy, and when the sentiment ‘we wish we could do a RCT but we can’t’ is true, and when it is not. Thoughts?

About Don Taylor
Professor of Public Policy at Duke University (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute). I am one of the founding faculty of the Margolis Center for Health Policy, and currently serve as Chair of Duke's University Priorities Committee (UPC). My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

4 Responses to RCTs in Economics

  1. Jess says:

    Ethics is as import for RCTs in development economics as it is for RCTs in medicine. While medical researchers have not always lived up to their own standards in this area, the development profession (my own field) has a particularly poor track record in studying – and changing – the lives of poor people. While the ethics of conducting RCTs in development economics has received considerable attention, as far as I am aware there is no development economics equivalent to the Helsinki Declaration.

    To use Bellemare’s example, is it ethical to observe children’s school attendance and performance, but to not to provide deworming medication to the control group? Can equipose truly be assumed? In other words, would YOU rather your child was in the treatment group or the control group?

    • Don Taylor says:

      @Jess
      Interesting point about different disciplines having different levels of ethics/conventions about conduct of research. Similarly, I think that RCTs in pharmaceuticals are ahead of the game on aggregating/reporting results.

      I think that in pharma research, most participants would rather be in treatment group as well, because it holds out hope for a ‘miracle cure’ but it does seem different if control is to observed something (truancy) that we are almost certain is bad.

  2. Brad F says:

    Don
    On the ethics of RCTs and pharma, things are changing. Are they (pharma), playing by the rules? You be the judge:

    http://www.vanityfair.com/politics/features/2011/01/deadly-medicine-201101

    Brad

  3. Don Taylor says:

    @Brad F
    Interesting article. This makes the point that just having a set of rules and procedures for reporting results doesn’t mean everything is as it should be. The pharma RCTs world is big and has many issues and many involved. Many of my questions go to issues of RCTs for other interventions, like palliative care. Or disease management. You could have the issue of internal validity straight (x causes y), but have no external validity (not replicable). I will try and sketch out some of these thoughts more clearly and post next week.

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