Here's one to mull over with your morning cup of coffee:
Criteria for evaluating evidence on public health interventions
J Epidemiol Community Health 2002;56 119-127
http://jech.bmjjournals.com/cgi/content/abstract/56/2/119
L Rychetnik,Effective Healthcare Australia, School of Population Health and
Health Services Research, University of Sydney, Australia
P Hawe and A Shiell, Department of Community Health Sciences, University of
Calgary, Canada and School of Public Health, LaTrobe University, Australia
"......Public health interventions tend to be complex, programmatic, and
context dependent. The evidence for their effectiveness just be sufficiently
comprehensive to encompass that complexity. This paper asks whether and to
what extent evaluative research on public health interventions can be
adequately appraised by applying well established criteria for judging the
quality of evidence in clinical practice. It is adduced that these criteria
are useful in evaluating some aspects of evidence. However, there are other
important aspects of evidence on public health interventions that are not
covered by the established criteria.
The evaluation of evidence must distinguish between the fidelity of the
evaluation process in detecting the success or failure of an intervention,
and the success or failure of the intervention itself. Moreover, if an
intervention is unsuccessful, the evidence should help to determine whether
the intervention was inherently faulty (that is, failure of intervention
concept or theory), or just badly delivered (failure of implementation).
Furthermore, proper interpretation of the evidence depends upon the
availability of descriptive information on the intervention and its context,
so that the transferability of the evidence can be determined. Study design
alone is an inadequate marker of evidence quality in public health
intervention evaluation......."
Dan Sontheimer, MD
Associate Director Spartanburg Family Medicine Residency
Spartanburg, SC
[log in to unmask]
|