I agree with point 2 to some extent but not point one. We have direct evidence from multiple randomized controlled trials that show us without much doubt that the best interventions are 10-100x more cost effective at saving lives than many others. Like @Cody_Fenwick says maybe not 1,000
Just because an intervention is complex doesn’t necessarily mean the outcome is complex as well. Many complex interventions are more measurable than we think.
I really enjoyed reading your HSS post and think you have some great points in there. I like how you take out some of the vague language of ‘intervening in complex systems’ that is often used to justify unsuccessful top down managerial changes in large organisations. Most complexity theory that I have come across would absolutely
I think the Mulago foundation article has some great points, such as trust and data not being mutually exclusive. Toby Lowe also has a great talk about this. But the article is also is too dismissive of applying non-quantitative funding e.g. to illiterate groups, or groups working on changing cultural values through art. I think the article is written to be clickbaity and controversial, which is a style I don’t find especially constructive.
I think the reason you disagree with point one might be that you are interpreting ‘complex systems’ still in the healthcare service provision field, whereas when it comes to health I would extend it to systems such as air pollution and income inequality, which are highly bound to complex political systems, where interventions are hard to measure using RCTs due to small sample sizes and a lack of counterfactuals. As has become my catch phrase, most disagreement is a result of miscommunication.
I agree with point 2 to some extent but not point one. We have direct evidence from multiple randomized controlled trials that show us without much doubt that the best interventions are 10-100x more cost effective at saving lives than many others. Like @Cody_Fenwick says maybe not 1,000
Just because an intervention is complex doesn’t necessarily mean the outcome is complex as well. Many complex interventions are more measurable than we think.
I discuss this a littler more here https://forum.effectivealtruism.org/posts/w44oxwXpRkzyEEEHr/the-best-health-systems-strengthening-interventions-barely
Here’s some good reflections as well from Kevin Starr from Mulago foundation along similar lines
https://www.mulagofoundation.org/articles/in-numbers-we-trust
Yes there are interventions which are hard to measure, but not as often as we might think.
I really enjoyed reading your HSS post and think you have some great points in there. I like how you take out some of the vague language of ‘intervening in complex systems’ that is often used to justify unsuccessful top down managerial changes in large organisations. Most complexity theory that I have come across would absolutely
I think the Mulago foundation article has some great points, such as trust and data not being mutually exclusive. Toby Lowe also has a great talk about this. But the article is also is too dismissive of applying non-quantitative funding e.g. to illiterate groups, or groups working on changing cultural values through art. I think the article is written to be clickbaity and controversial, which is a style I don’t find especially constructive.
I think the reason you disagree with point one might be that you are interpreting ‘complex systems’ still in the healthcare service provision field, whereas when it comes to health I would extend it to systems such as air pollution and income inequality, which are highly bound to complex political systems, where interventions are hard to measure using RCTs due to small sample sizes and a lack of counterfactuals. As has become my catch phrase, most disagreement is a result of miscommunication.
Interested to hear your thoughts