Abstract
Evidence-based policy is limited by the perception that randomized controlled trials (RCTs) are expensive and infeasible. We argue that carefully tailored research design can overcome these challenges and enable more widespread randomized evaluations of policy implementation. We demonstrate how a stepped-wedge (randomized rollout) design that adapts synthetic control methods overcame substantial practical, administrative, political, and statistical constraints to evaluating King County's new food safety rating system. The core RCT component of the evaluation came at little financial cost to the government, allowed the entire county to be treated, and resulted in no functional implementation delay. The case of restaurant sanitation grading has played a critical role in the scholarship on information disclosure, and our study provides the first evidence from a randomized trial of the causal effects of grading on health outcomes. We find that the grading system had no appreciable effects on foodborne illness, hospitalization, or food handling practices but that the system may have marginally increased public engagement by encouraging higher reporting.
References
Oct 7, 1998·Acta Psychiatrica Scandinavica·A Stravynski, D Greenberg
Jul 27, 2000·The Journal of Hand Surgery·V R Hentz
Sep 1, 2000·Public Health Reports·E R ZellR A Wright
Mar 6, 2003·Statistical Methods in Medical Research·A Agresti
Jul 11, 2006·Contemporary Clinical Trials·Michael A Hussey, James P Hughes
Jul 19, 2007·Journal of Policy Analysis and Management : [the Journal of the Association for Public Policy Analysis and Management]·Gary KingHector Hernandez Llamas
Mar 11, 2008·Lancet·Lia C H FernaldLynnette M Neufeld
Mar 18, 2011·Journal of Clinical Epidemiology·Noreen D MdegeDavid J Torgerson
Apr 13, 2013·Evidence-based Dentistry·Hu Long, Wenli Lai
Dec 18, 2013·Annual Review of Food Science and Technology·Jerry W King
Jan 21, 2015·American Journal of Public Health·Melissa R WongDaniel Kass
Feb 11, 2015·BMJ : British Medical Journal·K HemmingR J Lilford
Aug 19, 2015·Trials·Gianluca BaioRumana Z Omar
Nov 1, 2015·American Journal of Health Promotion : AJHP·Corneel Vandelanotte, Carol A Maher
Jun 2, 2016·The New England Journal of Medicine·Laura E BothwellDavid S Jones
Jun 29, 2016·Statistics in Medicine·Richard HooperSandra Eldridge
Oct 14, 2017·Statistical Methods in Medical Research·J KaszaA B Forbes
Nov 22, 2017·Nanomaterials·Fozia ShaheenMukhtar Ahmed
Jan 15, 2018·Social Science & Medicine·Angus Deaton, Nancy Cartwright
Oct 18, 2018·Evaluation Review·Natalie TodakAndrea R Borrego