Evidence based

Evidence based practice and policy sounds very cool. It instills a sense of… what’s the word? When you feel something you do is irrefutable because it is scientific, trustworthy, thought through, robust, etc. Since it successfully took off in medicine (at least the propagators seem to suggest it did), many jumped the bandwagon of making everything evidence based. It feels like when you say that something is evidence based, it sounds impressive and disarms the argument against whatever. People talking about evidence often speak with a sense of surety and you can’t really argue with it.

I know some organisations outside of medicine that seem determined to be evidence based. Those I worked with would typically claim that they want their programme design and delivery to be more evidence based so they end up setting up sophisticated systems and collecting hundreds or thousands of datasets. It sounds compelling and worth applauding. The key assumption is seems that making data based decisions are more superior than non-evidence based. Evidently evidence gives you the edge in decision making.

However, it raises one difficult question: can people use that evidence to make better decisions? And do those evidence based decisions lead to better outcomes? It turns out that bit of the decision was not really evidence based. The managers pushing for evidence typically make non-evidence based decision. So it is ironic that the decision to be evidence based is not evidence based. So we end up chasing and embracing fads without asking the question if this will actually work for us.

For a long time, I was frustrated with my colleagues who did not look at data that my team collected at the sweat of our brow and I toiled so hard to make sure the systems and processes were reliable. It turns out, people typically knew enough about the context and the project to make decisions, so looking at data would not necessarily enhance their decision making. A number of times we looked at data, it created questions for those who were not frontline. Those at the frontline knew and coped well enough without data. In the end it was not improving decisions, only control.