When Once Is Not Enough
[From the blog “Be careful what you wish for: cautionary tales on using single studies to inform policymaking” by Emmanuel Jimenez, posted at http://www.3ieimpact.org.]
“For a development evaluator, the holy grail is to have evidence from one’s study be taken up and used in policy or programming decisions that improve people’s lives.”
“In 2014, an article published in The Lancet reported the efficacy of a new vaccine, Dengvaxia, in dramatically lowering the incidence of the disease. The drug was approved in 19 countries, including the Philippines. In late 2016, the Philippines procured millions of doses and, over the span of 18-24 months, proceeded to inoculate some 800,000 school children.”
“There are now criminal charges being considered against the researcher and health officials, who sanctioned the programme. While the clinical trials were apparently well-conducted, there is doubt about how policies were drawn from them. Apparently, the vaccine, while very effective as a prophylactic for those who have already been exposed to dengue, may actually be dangerous for those who have never had it.”
“One lesson is the danger of relying on single studies to inform policy. Multiple contextual factors can influence effectiveness. To the extent possible, synthesise evidence through rigorous theory-based systematic reviews that include meta-analysis.”
“3ie is not only supporting this work but it is also facilitating access to evidence through our systematic review repository.”
“A final lesson is the importance of promoting research transparency and replications. The public inquiry into the Dengvaxia episode was prompted by a healthy scholarly debate which included policymakers. A critical aspect is the replication of scientific work. The ‘crisis’ caused by the inability to replicate some highly influential studies (including in the social sciences) is beginning to change how research is done.”
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