To start with needing evidence based policy, could we please have the following which by evidence are shown to be good policy:

ditch the war on drugs;
cessation of private school funding and increase of government school funding;
a lot of infrastructure money to be earmarked only for mass-transit upgrades in our cities to improve air quality, travel times, and ease the budget burden of high petrol prices;
delete the phrase "advancement of religion" from the Tax Act and make Churches pay tax on revenues and report their full accounts to the ATO, other organisations in charity, sport, research etc would continue being tax free.

Anyone who saw Penny Wong on Four Corners last night will realize that the Government is not interested in 'evidenced based policy'. She was shown to be woefully incompetent and full of rhetoric in wasting tax payers money in purchasing a property (with little to no water) in order to buy back water. She could not even remember who her advisers were in dishing out this 23 million dollars. The owners of the property literally are laughing all the way to the bank.This Government more than any is about dogma not evidence based policy. Thankfully the global recession will force them to stop squandering the piggy bank (I hope) unless of course they follow Whitlam's lead.

There are two major points that I would like to address from the current article. Due to the length of my post I will put the two different points in two different comment boxes.

The first point is to explore why Kevin Rudd has not used any Randomised Controlled Trial (RCT) studies to make his current policy decisions:

As the author points out, randomised controlled trials (RCT) take a long time: especially when assessing the effectiveness of policy. The briefest of trials would take at least 1.5 - 2 years to complete. A more realistic expectation is 3 years.

Kevin Rudd has been in power for just over 10 months. In this time he could not have completed any RCTs to assist in his policy decision making.

To me, the lack of available evidence merely indicates that the previous government failed to initiate any RCTs in the time they were in power.

Ironically, the author has provided flawed evidence in support of his statement that Kevin Rudd is not acting upon his rhetoric regarding “building an evidence base” for policy. The question the author should have asked is: is Kevin Rudd initiating new research or providing new funding for research that specifically assesses the efficacy of policy (particularly RCTs).

If you answer that question you will have a better indication on Kevin Rudd’s actions regarding building an evidence base for policy decisions. I don’t know that answer to the question myself (although I am aware of and additional $100 million from the Federal Government being put into the National Health and Medical Research Council specifically to focus on policy and practice relevant research in the health system).

The second point I would like to address is the narrow view the author takes with his belief that a RCT is the only type of study that allows a policy to be ‘evidence based’.

Whilst RCT evidence doesn’t exist for a large number of policy-decisions, fortunately the best available evidence is okay in most cases. There are observational, epidemiological, matched case-control studies, and strong theoretical bases on which the government can make policy decisions. Additionally, there are often multiple studies on each policy topic, which allow the decision-makers to use converging evidence to make their decisions. This is why $90 billion dollars can be spent on policy decisions in lieu of the ‘gold standard’ of evidence.

In my view, using the best available evidence to make necessary, timely policy decisions is far more appealing and pragmatic than refusing to spend any money for 3 years while waiting for a RCT to yield results.

As long as the government is concurrently evaluating these policies and initiating new research that will allow them to make tighter ‘evidence based’ decisions in the future, then I think that they are successfully acting upon Kevin Rudd’s ‘evidence based’ rhetoric.

Dear jaranet
"Whilst RCT evidence doesn’t exist for a large number of policy-decisions, fortunately the best available evidence is okay in most cases. There are observational, epidemiological, matched case-control studies, and strong theoretical bases on which the government can make policy decisions". While epidemiological and matched case-control studies may fall under the umbrella of "evidence -based" policy evaluation the rest clearly aren't and "strong theoretical bases" are the antitheses of "evidence-based" policy determination.
Accept 'evidence-based" policy determination as just the 21st century managerial/politico mumbo jumbo for the 90s PPR...Policy, Performance and Review which figured prominantly in every Strategic Plan but nary a cent was spent on measuring performance. So one ended up with subjective qualitative policy evaluations which surprisingly gave the "right" result.

Thanks blairbar,
You’re right - “strong theoretical basis” is not an example of evidence-based policy (although it should be a precursor). I can assure you, however, that observational studies fall squarely under the evidence-based umbrella. With large samples and adjustment for differences between comparison groups/changes over time, they can provide very robust results.

Regardless, it is clear that there is evidence other than RCT that can be used to form evidence-based policy.

With regard to your cynicism on “evidence-based” policy, I do share this view to a certain extent. Too often in the past “evaluation” studies have chosen to focus on “process” and “satisfaction” without examining real outcomes. We rarely ever see publications on the evaluation of policy “effectiveness” (due to inadequate collection of data, waning interest, burying contrary results, acceptance of “process” and “satisfaction” evaluation as being acceptable by many bureaucrats).

However, my cynicism is gradually waning for two major reasons: the first is the $100 million provided by the Federal government to conduct research into health policy and practice. This money is to be distributed through the NHMRC who are notoriously stringent on providing funding to only the most rigorous of study designs. I believe that the majority of this funding will go to randomised controlled trials and community-based comparisons to evaluate policy-effectiveness (hopefully this will result in calls for evaluations in other areas of policy, such as finance). The second reason is based on the WA Health Conference run by the Department of Health in WA (WADoH). Part of this conference was to showcase research that was designed and conducted by clinicians and policy-makers within the WADoH (in partnership health researchers). Much of this research aimed to evaluate the effectiveness of new policy and practice. The enthusiasm showed by the clinicians and policy-makers within the DoH indicated to me that the culture of ensuring “evidence based policy and practice” has permeated from the upper levels of government through to the service deliverers. And when the rhetoric of politicians transfers to the beliefs and actions of the “people on the ground”, this indicates that real change has occurred.