David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jack Alan Reynolds
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Journal of Evaluation in Clinical Practice 16 (2):260-266 (2010)
What kinds of evidence reliably support predictions of effectiveness for health and social care interventions? There is increasing reliance, not only for health care policy and practice but also for more general social and economic policy deliberation, on evidence that comes from studies whose basic logic is that of JS Mill's method of difference. These include randomized controlled trials, case–control studies, cohort studies, and some uses of causal Bayes nets and counterfactual-licensing models like ones commonly developed in econometrics. The topic of this paper is the 'external validity' of causal conclusions from these kinds of studies. We shall argue two claims. Claim, negative: external validity is the wrong idea; claim, positive: 'capacities' are almost always the right idea, if there is a right idea to be had. If we are right about these claims, it makes big problems for policy decisions. Many advice guides for grading policy predictions give top grades to a proposed policy if it has two good Mill's-method-of difference studies that support it. But if capacities are to serve as the conduit for support from a method-of-difference study to an effectiveness prediction, much more evidence, and much different in kind, is required. We will illustrate the complexities involved with the case of multisystemic therapy, an internationally adopted intervention to try to diminish antisocial behaviour in young people
|Keywords||capacities multisystemic therapy randomized controlled trials external validity|
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References found in this work BETA
Nancy Cartwright (1999). The Dappled World: A Study of the Boundaries of Science. Cambridge University Press.
Alexander Bird (2007). Nature's Metaphysics: Laws and Properties. Oxford University Press.
Gerd Gigerenzer (1999). Simple Heuristics That Make Us Smart. Oxford University Press.
Nancy Cartwright (1989). Nature's Capacities and Their Measurement. Oxford University Press.
Anjan Chakravartty (2007). A Metaphysics for Scientific Realism: Knowing the Unobservable. Cambridge University Press.
Citations of this work BETA
Brendan Clarke, Donald Gillies, Phyllis Illari, Federica Russo & Jon Williamson (2014). Mechanisms and the Evidence Hierarchy. Topoi 33 (2):339-360.
Jonathan Fuller (2013). Rhetoric and Argumentation: How Clinical Practice Guidelines Think. Journal of Evaluation in Clinical Practice 19 (3):433-441.
Jonathan Fuller (2013). Rationality and the Generalization of Randomized Controlled Trial Evidence. Journal of Evaluation in Clinical Practice 19 (4):644-647.
Michael Loughlin, Robyn Bluhm, Stephen Buetow, Ross E. G. Upshur, Maya J. Goldenberg, Kirstin Borgerson, Vikki Entwistle & Elselijn Kingma (2012). Reason and Value: Making Reasoning Fit for Practice. Journal of Evaluation in Clinical Practice 18 (5):929-937.
Michael Loughlin, Ross E. G. Upshur, Maya J. Goldenberg, Robyn Bluhm & Kirstin Borgerson (2010). Philosophy, Ethics, Medicine and Health Care: The Urgent Need for Critical Practice. Journal of Evaluation in Clinical Practice 16 (2):249-259.
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