Harvard Kennedy School.
J-PAL North America.
Milbank Q. 2021 Dec;99(4):864-881. doi: 10.1111/1468-0009.12521. Epub 2021 Jul 20.
Policy Points Policymakers at federal and state agencies, health systems, payers, and providers need rigorous evidence for strategies to improve health care delivery and population health. This is all the more urgent now, during the COVID-19 pandemic and its aftermath, especially among low-income communities and communities of color. Randomized controlled trials (RCTs) are known for their ability to produce credible causal impact estimates, which is why they are used to evaluate the safety and efficacy of drugs and, increasingly, to evaluate health care delivery and policy. But RCTs provide other benefits, allowing policymakers and researchers to: 1) design studies to answer the question they want to answer, 2) test theory and mechanisms to help enrich understanding beyond the results of a single study, 3) examine potentially subtle, indirect effects of a program or policy, and 4) collaborate closely to generate policy-relevant findings. Illustrating each of these points with examples of recent RCTs in health care, we demonstrate how policymakers can utilize RCTs to solve pressing challenges.
政策要点联邦和州机构、卫生系统、支付方和服务提供方的决策者需要严格的证据来制定改善医疗服务提供和人口健康的策略。在 COVID-19 大流行及其余波期间，尤其是在低收入社区和少数族裔社区，这一点更加紧迫。随机对照试验（RCT）以其能够产生可信因果影响估计的能力而闻名，这就是为什么它们被用于评估药物的安全性和有效性，并且越来越多地用于评估医疗服务提供和政策。但是，RCT 还有其他好处，使决策者和研究人员能够：1）设计研究来回答他们想问的问题，2）检验理论和机制，以帮助丰富对单一研究结果的理解，3）检查计划或政策的潜在微妙、间接影响，4）密切合作以产生与政策相关的发现。我们用医疗保健领域最近的 RCT 示例来说明每一点，展示了决策者如何利用 RCT 来解决紧迫的挑战。
