CEDAR researchers and collaborators have recently published a paper in BMJ Global Health. Making sense of the evidence in population health intervention research: building a dry stone wall
But why a dry stone wall? On one hand it sometimes feels you can’t move for all the new research coming out. It’s hard to see the wood for the trees. But in our field you also often hear the phrase “More research is needed” before we can decide what to actually do about our diets, transport or welfare systems to improve public health.
In fact systematic reviews and guidance development groups often say the available evidence about the effects of population health interventions is too diverse, flawed or inconclusive to support conclusions about action.We could ask then whether the craft of evidence synthesis is fit for purpose in population health intervention research. This new paper proposes a more eclectic, flexible and reflexive approach to making sense of the available evidence.
To better understand what makes for an effective public health strategy, we should look beyond simple notions of ‘interventions’, search for patterns and embrace the mess. Because you can’t build much without getting your hands dirty. Evidence is rarely clear cut, and we’re always going to debate many details. But what if we embrace a spirit of pragmatic pluralism, robust enough to guide action while adapting to the contours of the public health landscape?
Dry stone walling is a way of transforming a pile of stones, which at first glance don’t fit together, into something new and useful. Each stone is considered in its own right and assigned a unique place in the wall. No mortar is needed, because careful thought is given to how all the pieces used together can form a structure that is more than the sum of its parts. The art can be learned, but it needs flexibility and ingenuity that you can’t easily get from a manual.
This paper explores how this art can stand as a metaphor for the ‘holistic sense-making’ required of the evidence in population health intervention research.
- Making sense of the evidence in population health intervention research: building a dry stone wall. David Ogilvie, Adrian Bauman, Louise Foley, Cornelia Guell, David Humphreys, Jenna Panter. BMJ Global Health 2020 http://dx.doi.org/10.1136/bmjgh-2020-004017
- Listen to Dr David Ogilvie talk about this paper and other research on the MRC Epidemiology Unit podcast The Confidence Interval