Meta-analysis App?

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Coming soon, AidGrade will release a full-fleged version of its meta-analysis app; that is, an app that allows users to utilize pre-extracted research report data to organize and conduct a meta-analysis in a matter of minutes. You can read a bit more about their processes here, and here.

This seems like an app that students, alumni, and faculty of EBSI Oxford could be well-positioned to discuss/debate/critique/endorse….

Is the AidGrade app a good idea? What potential drawbacks or dangers does it present? Are there ways it could be improved, or should it just not be used at all? Take a moment (or more) to glance over AidGrade’s app and plans, and leave your feedback below!

Global Impact Blog: Equipoise in Development RCTs

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In a recent article on the World Bank’s Development Impact blog, author David Mackenzie discusses the role of equipoise in RCTs for impact assessments. Mackenzie summarizes previous arguments thus:

‘In public health research, the justification for randomly assigning participants is based on clinical equipoise. This means that clinical trials are implemented only when, the researchers have substantial uncertainty (doubt) about the expected impact (efficacy) of the intervention (drug)…But in the development sector, economists are not aware of the need to establish clinical equipoise before conducting RCTs of development interventions. Since RCTs are being increasingly used by development economists, we should start thinking about how clinical equipoise can be established for impact evaluations of development interventions.’

This sentiment is not necessarily echoed by Mackenzie himself, however.

My problem with [arguments such as this] is that they seem to be understanding clinical equipoise in terms of needing uncertainty about whether or not some intervention makes people better off, without taking into account the costs of doing so relative to “how much” better off the intervention makes people. But we don’t live in a world of no budget constraints, and so the standard of clinical equipoise needs to be more along the lines of doubts over whether this use of funds makes people better off relative to any other possible use of funds in the country, or for international organizations, the world. Anyone who thinks there is not considerable uncertainty about this question is likely deluding themselves.

Mackenzie then provides four points upon which he believes impact assessments in the development context can approve.

Recommended Post: Is it nuts to give money to the poor?

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In a recent blog post, Columbia professor and development cash transfer expert Chris Blattman states the following:

“Neither the government nor the charity I worked with in Uganda were willing to try [giving people] just cash…[A radio show] talked to a woman from Heifer International, who give cows and training instead of cash. That could be the right thing to do. But she couldn’t bear the thought of finding out. She hated the idea of experimenting on poor people. They are human beings.
Let me be blunt: This is the way the Heifers of the world fool themselves. When you give stuff to some people and not to others, you are still experimenting in the world. You are still flipping a coin to decide who you help and who you don’t, it’s just an imaginary one.

You’re experimenting with your eyes closed.

This is a somewhat controversial statement that bumps up against our knee jerk reactions and engrained intervention norms. But are those norms unreasonable? EBSI students, faculty, and alums, chime in! In fact, we’d like to hear from anyone in the intervention community.


footnoteA similar phenomenon exists in studying the effects of day care. Governments and ngos are extremely reticent to utilize an RCT to study the effects of just daycare on children and families; they see it as unethical to withhold such a program from some children but not others.

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NYT: Medical Procedures May Be Useless, or Worse

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A recent blogpost at the New York Times, and the Mayo Clinic report it references, may be of interest to evidence-based aficionados:

“We usually assume that new medical procedures and drugs are adopted because they are better. But a new analysis has found that many new techniques and medicines are either no more effective than the old ones, or worse. Moreover, many doctors persist in using practices that have been shown to be useless or harmful.

Scientists reviewed each issue of The New England Journal of Medicine from 2001 through 2010 and found 363 studies examining an established clinical practice. In 146 of them, the currently used drug or procedure was found to be either no better, or even worse, than the one previously used. The report appears in the August issue of Mayo Clinic Proceedings…” – Nocholas Bakalar, New York Times

BMJ takes further steps to combat bad reporting

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In an added effort in the fight against bad trial reporting, BMJ has released an article encouraging study authors to include a “declaration of transparency” when reporting study findings. “Bad as non-publication is,” says the article, “incomplete or misleading publications cause greater problems,…selective non-publication favours statistically significant findings, biasing the literature…Omission of important details of methods or study conduct should be deemed unacceptable, and journals should not publish them.”

The statement that this article calls on study authors to sign along with the submission of any study report reads as follows:

“The lead author* affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

*The manuscript’s guarantor”

Development Impact Blog

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For those interested in international development and impact evaluation, the WorldBank’s Development Impact blog may be a good tromping ground for readings and discussion/debate. Recent posts have included:

(The New Yorker) Atul Gawande: How Do Good Ideas Spread?

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“To create new norms, you have to understand people’s existing norms and barriers to change. You have to understand what’s getting in their way. So what about just working with health-care workers, one by one, to do just that? With the BetterBirth Project, we wondered, in particular, what would happen if we hired a cadre of childbirth-improvement workers to visit birth attendants and hospital leaders, show them why and how to follow a checklist of essential practices, understand their difficulties and objections, and help them practice doing things differently. In essence, we’d give them mentors.

The experiment is just getting under way. The project has recruited only the first few of a hundred or so workers whom we are sending out to hospitals across six regions of Uttar Pradesh in a trial that will involve almost two hundred thousand births over two years. There’s no certainty that our approach will succeed. But it seemed worth trying.”

Read the entire article here.

mHealth and evidence

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“Mobile health (mHealth) is the provision of health services and information via mobile and wireless technologies. Within [many developing countries] the mobile phone has become ubiquitous, making mHealth applications an important tool with which to impact the health of [citizens]. When applied correctly, mHealth can make real contributions to improved health outcomes. mHealth has the potential to address and overcome (1) disparities in access to health services; (2) inadequacies of the health infrastructure within countries; (3) shortage of human resources for health; (4) high cost of accessing health; and (5) limitations in the availability of financial resources” (mHealth Compendium vo. 2). That said, like all interventions, mHealth interventions can have unforeseen side-effects that necessitate well-designed impact evaluation. For this reason, a new website designed in partnership with Johns Hopkins School of Public Health has been created to serve as the epicenter of mHealth evidence. mhealthevidence.org includes advanced search…

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Webinar on Policy Dimensions of Scaling up Family Planning & MCH Services

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Webinar Title:  Policy Dimensions of Scaling up Family Planning and MCH Services
Date:  Thursday, July 11, 2013
Time:  12:00 PM – 1:00 PM EDT

Effective policy development is critical to the successful and sustainable scale-up of family planning and maternal, neonatal, and child health interventions. In this presentation Dr. Karen Hardee addresses the implementation of supportive policies and systems that enhance the sustainability of scale-up initiatives. Dr. Hardee gave this presentation at the Women Deliver Conference in May as part of a satellite session hosted by the Gender, Policy and Measurement (GPM) program, an activity of the USAID-supported Health Policy Project. Following the presentation, Karen will lead a lively discussion and interactive Q&A session on topics related to the presentation. This is the first in a series of webinars hosted by the Community of Practice on Scale-up and Gender, Policy and Measurement.

Please note the presentation…

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Systematic Review : The global prevalence of intimate partner homicide

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EBSI doctoral graduate Heidi Stockl has a new review publish with the Lancet on the global prevalence of intimate partner violence. Her findings, gathered form 66 countries, suggest that 13·5% (IQR 9·2—18·2) of homicides were committed by an intimate partner, and this proportion was six times higher for female homicides than for male homicides (38·6%, 30·8—45·3, vs 6·3%, 3·1—6·3). Put in context, this means that “at least one in seven homicides globally and more than a third of female homicides are perpetrated by an intimate partner.

This review is a timely publication that coincides the World Health Organization’s report on intimate partner violence that has recently garnered much attention in the news. (Dr. Stockl and her co-authors also worked on that report). The WHO report gives further breadth and detail to the topic of intimate partner violence, while also providing a much needed document on the current best practices for responding to intimate partnern violence.

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