Evidence-Based Policy

Evidence-based policy making (EBP) has developed over the past 40 years from conceptual roots that lie in the health care profession. Its deeper intellectual roots can be traced back even further to the Enlightenment, the policy sciences movement in the mid-20th century, and efforts to address societal ills through informed and activist government in the 1960s. Definitions of EBP may vary, but most observers agree that EBP requires rational and systematic processes for producing evidence to be applied in the policy making process. While differences in definitions of EBP tend to focus on variations on this idea, there is debate about the kinds of evidence that should be collected, EBP's feasibility as an actual guide for policy making, and the standards of evidence that it requires. In this sense, EBP shares challenges that are similar to earlier movements that sought to rationalize policy making and policy-making processes.

EBP's more recent conceptual roots lie in research on health care practices. In 1971, Archibald Cochrane, a British epidemiologist, highlighted gaps between the state of medical knowledge and the realities of medical practice. He advocated more systematic research on patient care as well as on the systematic application of knowledge gained through this research to clinical practice. In the early 1990s, his hope for more systematic assessments of clinical practices and their use in guiding patient care was realized when the international Cochrane Collaboration was established in Oxford, United Kingdom (UK), to execute systematic reviews of medical evidence. The work of the Cochrane Collaboration and the nearby Centre for Evidence-Based Medicine at John Radcliffe Hospital in Oxford caught the attention of policymakers in the UK, the United States, and elsewhere.

Research on evidence-based medicine gave rise to practical applications in both health care and other policy sectors. As Sue Dopson, Louise Locock, John Gabbay, Ewan Ferlie, and Louise Fitzgerald (2003) note, in the health care sector, the UK and the United States promoted the application of evidence-based research and practice in various ways, including the establishment of guidelines and research centers to encourage the use of systematic medical research findings in clinical practices. In the UK, the Labour government of the 1990s embraced the EBP concept and expanded it to other policy areas as a part of its efforts to modernize government. The Labour Government's 1999 Cabinet Office White Paper on Modernizing Government, for example, highlighted the importance of evidence and research in policy making across the board, not just in the health care arena. In an effort to ensure that public policies actually work to achieve their objectives, the UK also increased funding for social research during this time period.

In recent years, the phrase evidence-based policy making has been used with increasing frequency. For example, the title of the Association of Public Policy Analysis and Management's (APPAM) Annual Research Conference in Washington, D.C., during the fall of 2009, was “Evidence-Based Policy Making in the Post Bush/Clinton Era.” This title reflects recognition of the importance of the phrase not only in the UK, where it has been commonly used, but also in North America and elsewhere as well.

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