How randomized trials are starting to meet the Goldacre standard

Bridging the treacherous divide between good science writing and the newsroom with a smart combination of penetrating analysis and good humor has made The Guardian’s weekly Bad Science column one of the success stories of print journalism in the UK.

Writer Ben Goldacre has won a string of awards for articles that cleverly unpick the relationship between scientific method, politics and society and put pseudoscience, health fads and all other hooey cheerfully to the knife.

The provocativeness of Goldacre's writing has also made it fertile ground for bloggers. His 600-word Saturday column regularly generates several thousand words of reaction before the end of a Guardian weekend – which goes to explain why a recent Bad Science piece on a question not often aired in the UK lifestyle supplements, "Why don't we do randomized controlled trials (RCT's) on social policy?" produced so much stimulating comment. See The Testing of Social Policy.

“Like all the best problems,” Goldacre observed “the barriers are institutional and historical: and the objections raised against trials in social policy are exactly the same as those raised in medicine 40 years ago. Judges will say, as doctors once did: we have expertise, we know what works for an individual.” Many social workers will say the same.

“The sad reality is," he reflected, "social policies feel good, like alternative therapies; but, like alternative therapies, most policies don't work. In the field of recidivism, even from uncontrolled studies there aren't many successful interventions.”

All this raises two classes of question - one about the value and effective use of RCTs - the other, possibly by a short leap related to the first, the effectiveness of blogs as a vehicle for informed opinion,

One simple observation on the big puzzle – why policy makers rely so little on randomized controlled trials when they are reputedly so interested in evidenced-based thinking – might be that it’s a symptom of an English system that still sets professional status