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What counts as evidence? Some reflections on what counts as 'good enough' evidence in public health

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BRADFORD HILL SEMINAR: Mark's main research interests are in evidence-based policymaking, systematic reviews, and the evaluation of the health effects of social policies

It is often said that in the case of public health evidence ‘the best is the enemy of the good’, and that perfect evidence is not possible to obtain. At the same time, evidence synthesis methods have evolved considerably to help deal with imperfect evidence, and modern systematic reviews are increasingly characterised by a willingness to incorporate a wider range of study designs. With 12 systematic reviews published every day, we seem to live in a golden age of evidence. And yet… many systematic reviews, particularly reviews of complex interventions, fail to convince. The underwhelming conclusion is often that the evidence is ‘weak’ or ‘mixed’, or is very context-dependent – that is, it came from somewhere very different from here (evidential nimbyism?). Systematic reviews also still struggle to incorporate and integrate different types of evidence – such as different designs, and in particular evidence from different contexts. Is this really the best we can do? Are we making best use of the public health evidence we have, or have we reached ‘peak evidence’? This talk will consider whether we are over-obsessed with the quality of public health evidence, and will discuss some of the consequences.

The seminar will be introduced by Dr David Ogilvie, Programme Leader at the MRC Epidemiology Unit.

This talk is part of the Bradford Hill seminars at the Cambridge Institute of Public Health series.

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