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Good intentions and received wisdom are not enough
  1. MRC Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow G12 8RZ
  1. Professor Macintyre (sally{at}

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There is a common view among social and public health scientists that there is an evidence-based medicine (EBM) juggernaut, a powerful, naive, and overweening attempt to impose an inappropriately narrow and medical model of experimentation onto a complex social world. We have both frequently come across hostility among social scientists, and public health or health promotion practitioners or theorists, to attempts to apply EBM principles (for example, systematic reviews or experimental designs) in social or public health settings (for example, sex education in schools, health promotion campaigns, or community development1). We believe such hostility to be misplaced, and to be based on a number of misconceptions.

The first misconception is that systematic reviews and experimental designs have a wholly biomedical provenance. As Ann Oakley has pointed out, the use of experimental designs was well established in United States by the 1930s, and from the early 1960s to early 1980s there were many randomised experiments for evaluating public policy interventions in United States, these being considered the optimum design. Much of the early literature on experimental designs (including blinding) came from the social sciences, as a response to the perceived need to be able to make valid causal inferences.2

The second misconception is that the “real world” is too complex, messy, …

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