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How to find, use, and explain evidence.

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Tuesday, 27 September 2016

Improving vs. proving, plus bad evidence reporting.

Turtle slow down and learn something

If you view gathering evidence as simply a means of demonstrating outcomes, you’re missing a trick. It’s most valuable when part of a journey of iterative improvement. - Frances Flaxington

1. Immigrants to US don't disrupt employment.
There is little evidence that immigration significantly affects overall employment of native-born US workers. This according to an expert panel's 500-page report. We thought you might like this condensed version from PepperSlice.

Bad presentation alert: The report, The Economic and Fiscal Consequences of Immigration, offers no summary visuals and buries its conclusions deep within dense chapters. Perhaps methodology is the problem, documenting the "evidence-based consensus of an authoring committee of experts". People need concise synthesis and actionable findings: What can policy makers do with this information?

Bad reporting alert: Perhaps unsatisfied with these findings, Julia Preston of the New York Times slipped her own claim into the coverage, saying the report "did not focus on American technology workers [true], many of whom have been displaced from their jobs in recent years by immigrants on temporary visas [unfounded claim]". Rather sloppy reporting, particularly when covering an extensive economic study of immigration impacts.


Immigration

Key evidence: "Empirical research in recent decades suggests that findings remain by and large consistent with those in The New Americans (National Research Council, 1997) in that, when measured over a period of 10 years or more, the impact of immigration on the wages of natives overall is very small." [page 204]

Immigration also contributes to the nation’s economic growth.... Perhaps even more important than the contribution to labor supply is the infusion by high-skilled immigration of human capital that has boosted the nation’s capacity for innovation and technological change. The contribution of immigrants to human and physical capital formation, entrepreneurship, and innovation are essential to long-run sustained economic growth. [page 243]

Author: @theNASEM, the National Academies of Sciences, Engineering, and Medicine.

Relationship: immigration → sustains → economic growth


2. Improving vs. proving.
On @A4UEvidence: "We often assume that generating evidence is a linear progression towards proving whether a service works. In reality the process is often two steps forward, one step back." Ugly Research supports the 'what works' concept, but wholeheartedly agrees that "The fact is that evidence rarely provides a clear-cut truth – that a service works or is cost-beneficial. Rather, evidence can support or challenge the beliefs that we, and others, have and it can point to ways in which a service might be improved."


3. Who should make sure policy is evidence-based and transparent?
Bad PR alert? Is it government's responsibility to make policy transparent and balanced? If so, some are accusing the FDA of not holding up their end on drug and medical device policy. A recent 'close-held embargo' of an FDA announcement made NPR squirm. Scientific American says the deal was this: "NPR, along with a select group of media outlets, would get a briefing about an upcoming announcement by the U.S. Food and Drug Administration a day before anyone else. But in exchange for the scoop, NPR would have to abandon its reportorial independence. The FDA would dictate whom NPR's reporter could and couldn't interview.

"'My editors are uncomfortable with the condition that we cannot seek reaction,' NPR reporter Rob Stein wrote back to the government officials offering the deal. Stein asked for a little bit of leeway to do some independent reporting but was turned down flat. Take the deal or leave it."


Evidence & Insights Calendar

November 9-10, Philadelphia: Real-World Evidence & Market Access Summit 2016. "No more scandals! Access for Patients. Value for Pharma."

29 Oct-2 Nov, Vienna, Austria: ISPOR 19th Annual European Congress. Plenary: "What Synergies Could Be Created Between Regulatory and Health Technology Assessments?"

October 3-6, National Harbor, Maryland. AMCP Nexus 2016. Special topic: "Behavioral Economics - What Does it All Mean?"


Photo credit: Turtle on Flickr.

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