PRESIDENT’S CORNER
Statistics and Statisticians:
Essential to Evidence-Based
Decisionmaking
T
he Obama Administration is committed to means integrating individual clinical experience
policy decisions driven by evidence, as with the best available external clinical evidence
emphasized by Peter Orszag, director of the from systematic research.” Statistics is central to
Office of Management and Budget. The time is evidence-based medicine.
now to promote the use of statistics and the role of A variety of opportunities exist for the inter-
statisticians in making good decisions based on ested statistician to learn more about and partici-
objective evidence. pate in evidence-based medicine. For example, the
Evidence-based decisionmaking, including both Cochrane Collaboration (see www.cochrane.org),
a desire to be guided by evidence and to generate founded in 1993, was named after the epidemiolo-
new evidence, is broadly applicable, as noted in a gist Archie Cochrane. It is an international not-
2009 National Science Foundation (NSF) report for-profit independent organization dedicated to
sally C. Morton
titled “Social, Behavioral, and Economic Research providing information about health care treatments
in the Federal Context” (see
www.nsf.gov/sbe/ available worldwide. The collaboration produces
prospectus_v10_3_17_09.pdf). Indeed, the National and disseminates systematic reviews and promotes
Academies Division of Behavioral and Social Sciences the search for evidence in the form of clinical tri-
and Education established the Committee on als and other studies. In particular, the Cochrane
Social Science Evidence for Use (see www7. Handbook discusses statistical issues and provides
nationalacademies.org/DBASSE/Social_Science_ guidance on how to prepare a review.
Evidence_for_Use.html), whose charge is to address The Campbell Collaboration (see www.
questions on how best to strengthen the quality, campbellcollaboration.org), named for social scien-
use, and utility of social science research and to lay tist Donald Campbell, is a sister organization to the
a solid foundation for the continuous improvement Cochrane Collaboration that was begun in 2000.
of both the conduct of social science research and its It focuses on preparing, maintaining, and dissemi-
application to policy. nating systematic reviews in the social sciences (e.g.,
The use of evidence-based decisionmaking rang- crime, education, and social welfare).
es from education to the environment to criminal The Agency for Healthcare Research and Quality
justice to national security. In education, for exam- (AHRQ) Evidence-Based Practice Centers (EPCs)
ple, the What Works Clearinghouse (see http://ies. (see
www.ahrq.gov/clinic/epc) are an important source
ed.gov/ncee/wwc) was established in 2002 by the U.S. of systematic reviews and methodological guidance.
Department of Education’s Institute of Education EPCs are located in the United States and Canada.
Sciences to provide educators with evidence about In particular, EPCs have produced a methods refer-
the effectiveness of educational interventions ence guide that addresses statistical methods in sys-
and practices. tematic reviews.
A key tool to improving health care decision- Considerable attention in the health care reform
making is evidence-based medicine, a term that debate has been focused on comparative effective-
appeared in the early 1990s. Evidence-based medi- ness research, which might be called a subset of evi-
cine is defined by David Sackett and co-authors in dence-based medicine. The Institute of Medicine has
their BMJ editorial titled “Evidence Based Medicine: estimated that less than half of all health care treat-
What It Is and What It Isn’t” as “the conscientious, ments delivered today are supported by evidence.
explicit, and judicious use of current best evidence As defined by Carolyn Clancy and Jean Slutsky of
in making decisions about the care of individual AHRQ, the central question of comparative effec-
patients. The practice of evidence-based medicine tiveness research is which health care treatment
OCTObER 2009 AMsTAT NEWs 3
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