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Why it’s time to stop considering Evidence-Based Policy and Evidence-Based Medicine as analogous when it comes to Randomized Controlled Trials: An argument from Clinical Equipoise

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Zemmel, Charlotte 


Randomized Controlled Trials (RCTs) play a large role in both Evidence-Based Medicine (EBM) and Evidence-Based Policy (EBP). However, in this paper, I question whether the role of RCTs is directly analogous in the two movements. I centre my argument around the concept of ‘Clinical Equipoise’, a principle which states that an RCT in clinical research can only continue if there is ‘genuine uncertainty within the expert medical community about the preferred treatment’. By illustrating how there cannot be an equivalent ‘Policy Equipoise’ principle, I suggest that policymakers should proceed with caution when appropriating methods from EBM. I show how clinical practice and social policy rely on such different community structures that drawing analogies between EBM and EBP is misguided and can disadvantage Evidence-Based Policy-making.



Evidence-Based Policy, Evidence-Based Medicine, Randomized Control Trials, Clinical Equipoise

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Cambridge Journal of Science and Policy

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CUSPE (Cambridge University Science and Policy Exchange)

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