Some time has passed since the concept of evidence-based medicine (EBM) based on inductive reasoning, a descendant of the positivism that emerged in the 19th century, swept through the medical world in the early 1990s. Recent years have seen increased adoption of evidence-based policy making (EBPM) in politics and administration, which involves the formulation of policy based on evidence gathered after the policy objective has been clarified rather than on precedent or individual cases. In Japan, the Cabinet Office along with ministries and agencies are working across the board to promote EBPM. This book discusses the importance of literacy regarding research design and data interpretation from the standpoint of EBM and EBPM with the aim of contributing to the exploration of universal evidence-based decision-making methods that cut across disciplinary boundaries.
One of the unique features of this book is its focus on themes common to both medicine and economics, two disciplines that, at first glance, seem completely unrelated. In the first half of the book, the author Koichi MIYAKI, M.D., Ph.D., professor of public policy at University Tokyo introduces various examples and theories in epidemiology and public health to discuss the importance of EBM and EBPM, pitfalls of data interpretation and causal inference, correlations and causal inference, and the pitfalls of biases inherent to human cognition. The author also provides examples and measures to demonstrate that not all evidence carries the same weight, to explain the reliability of results from randomized controlled trials (RCTs) while also arguing that RCT is not the only research design that should be respected, and to explain classical Hill’s criteria for causation and counterfactual thinking. In the second half of the book, Yukio KORIYAMA, Ph.D., an old friend of the author and professor of economics at the Ecole Polytechnique, explains various methods for aggregating opinions and building consensus based on a discussion of mechanism design in game theory and voting theory; in addition, he provides various practical examples to highlight the importance not only of using theory but also of implementing measures and policies that resonate with people.
There is growing recognition of the problematic aspects of majority rule as a decision-making method, prompting efforts to identify better ways to arrive at socially-desirable alternatives. One such method is the “Majority Judgment” voting method used for participatory budgeting in Paris. The danger of the majority persecuting the minority has been discussed since the advent of modern democracy. The argument that the majority is allowed to practice tyranny is not a part of democracy. Recent years have seen robust discussion of decision-making methods that proactively use data to algorithmically arrive at “optimal” decisions. For such algorithms to function properly, it is critical that the process is overseen by discerning eyes (with data literacy and a normative awareness of how society should work). Our hope is for this book to be read by individuals who are interested in thinking about better ways to make social decisions and who want to contribute to the creation of better social systems. The authors would be most pleased if the book, through its practical examples, is able to convey both the complexity and excitement of applying insights from academic research to real life as well as the joy of cross-disciplinary research and social implementation.
(Written by MIYAKI Koichi, Project Professor, Graduate School of Public Policy / 2023)