Can "realist" randomised controlled trials be genuinely realist?

Sara Van Belle, Geoff Wong, Gillian Sue Westhorp, Mark Pearson, Nick Emmel, Ana Manzano, Bruno Marchal

Research output: Contribution to journalEditorialResearchpeer-review

4 Downloads (Pure)

Abstract

In this paper, we respond to a paper by Jamal and colleagues published in Trials in October 2015 and take an opportunity to continue the much-needed debate about what applied scientific realism is. The paper by Jamal et al. is useful because it exposes the challenges of combining a realist evaluation approach (as developed by Pawson and Tilley) with the randomised controlled trial (RCT) design. We identified three fundamental differences that are related to paradigmatic differences in the treatment of causation between post-positivist and realist logic: (1) the construct of mechanism, (2) the relation between mediators and moderators on one hand and mechanisms and contexts on the other hand, and (3) the variable-oriented approach to analysis of causation versus the configurational approach. We show how Jamal et al. consider mechanisms as observable, external treatments and how their approach reduces complex causal processes to variables. We argue that their proposed RCT design cannot provide a truly realist understanding. Not only does the proposed realist RCT design not deal with the RCT’s inherent inability to “unpack” complex interventions, it also does not enable the identification of the dynamic interplay among the intervention, actors, context, mechanisms and outcomes, which is at the core of realist research. As a result, the proposed realist RCT design is not, as we understand it, genuinely realist in nature.
Original languageEnglish
Article number313
Pages (from-to)1-6
Number of pages6
JournalTrials
Volume17
DOIs
Publication statusPublished - 2016
Externally publishedYes

Fingerprint

Randomized Controlled Trials
Causality
Research

Cite this

Van Belle, S., Wong, G., Westhorp, G. S., Pearson, M., Emmel, N., Manzano, A., & Marchal, B. (2016). Can "realist" randomised controlled trials be genuinely realist? Trials, 17, 1-6. [313]. https://doi.org/10.1186/s13063-016-1407-0
Van Belle, Sara ; Wong, Geoff ; Westhorp, Gillian Sue ; Pearson, Mark ; Emmel, Nick ; Manzano, Ana ; Marchal, Bruno. / Can "realist" randomised controlled trials be genuinely realist?. In: Trials. 2016 ; Vol. 17. pp. 1-6.
@article{e7415fbd90614c2fab56cb8bae178489,
title = "Can {"}realist{"} randomised controlled trials be genuinely realist?",
abstract = "In this paper, we respond to a paper by Jamal and colleagues published in Trials in October 2015 and take an opportunity to continue the much-needed debate about what applied scientific realism is. The paper by Jamal et al. is useful because it exposes the challenges of combining a realist evaluation approach (as developed by Pawson and Tilley) with the randomised controlled trial (RCT) design. We identified three fundamental differences that are related to paradigmatic differences in the treatment of causation between post-positivist and realist logic: (1) the construct of mechanism, (2) the relation between mediators and moderators on one hand and mechanisms and contexts on the other hand, and (3) the variable-oriented approach to analysis of causation versus the configurational approach. We show how Jamal et al. consider mechanisms as observable, external treatments and how their approach reduces complex causal processes to variables. We argue that their proposed RCT design cannot provide a truly realist understanding. Not only does the proposed realist RCT design not deal with the RCT’s inherent inability to “unpack” complex interventions, it also does not enable the identification of the dynamic interplay among the intervention, actors, context, mechanisms and outcomes, which is at the core of realist research. As a result, the proposed realist RCT design is not, as we understand it, genuinely realist in nature.",
author = "{Van Belle}, Sara and Geoff Wong and Westhorp, {Gillian Sue} and Mark Pearson and Nick Emmel and Ana Manzano and Bruno Marchal",
year = "2016",
doi = "10.1186/s13063-016-1407-0",
language = "English",
volume = "17",
pages = "1--6",
journal = "Trials",
issn = "1745-6215",
publisher = "BioMed Central",

}

Van Belle, S, Wong, G, Westhorp, GS, Pearson, M, Emmel, N, Manzano, A & Marchal, B 2016, 'Can "realist" randomised controlled trials be genuinely realist?', Trials, vol. 17, 313, pp. 1-6. https://doi.org/10.1186/s13063-016-1407-0

Can "realist" randomised controlled trials be genuinely realist? / Van Belle, Sara; Wong, Geoff; Westhorp, Gillian Sue; Pearson, Mark; Emmel, Nick; Manzano, Ana; Marchal, Bruno.

In: Trials, Vol. 17, 313, 2016, p. 1-6.

Research output: Contribution to journalEditorialResearchpeer-review

TY - JOUR

T1 - Can "realist" randomised controlled trials be genuinely realist?

AU - Van Belle, Sara

AU - Wong, Geoff

AU - Westhorp, Gillian Sue

AU - Pearson, Mark

AU - Emmel, Nick

AU - Manzano, Ana

AU - Marchal, Bruno

PY - 2016

Y1 - 2016

N2 - In this paper, we respond to a paper by Jamal and colleagues published in Trials in October 2015 and take an opportunity to continue the much-needed debate about what applied scientific realism is. The paper by Jamal et al. is useful because it exposes the challenges of combining a realist evaluation approach (as developed by Pawson and Tilley) with the randomised controlled trial (RCT) design. We identified three fundamental differences that are related to paradigmatic differences in the treatment of causation between post-positivist and realist logic: (1) the construct of mechanism, (2) the relation between mediators and moderators on one hand and mechanisms and contexts on the other hand, and (3) the variable-oriented approach to analysis of causation versus the configurational approach. We show how Jamal et al. consider mechanisms as observable, external treatments and how their approach reduces complex causal processes to variables. We argue that their proposed RCT design cannot provide a truly realist understanding. Not only does the proposed realist RCT design not deal with the RCT’s inherent inability to “unpack” complex interventions, it also does not enable the identification of the dynamic interplay among the intervention, actors, context, mechanisms and outcomes, which is at the core of realist research. As a result, the proposed realist RCT design is not, as we understand it, genuinely realist in nature.

AB - In this paper, we respond to a paper by Jamal and colleagues published in Trials in October 2015 and take an opportunity to continue the much-needed debate about what applied scientific realism is. The paper by Jamal et al. is useful because it exposes the challenges of combining a realist evaluation approach (as developed by Pawson and Tilley) with the randomised controlled trial (RCT) design. We identified three fundamental differences that are related to paradigmatic differences in the treatment of causation between post-positivist and realist logic: (1) the construct of mechanism, (2) the relation between mediators and moderators on one hand and mechanisms and contexts on the other hand, and (3) the variable-oriented approach to analysis of causation versus the configurational approach. We show how Jamal et al. consider mechanisms as observable, external treatments and how their approach reduces complex causal processes to variables. We argue that their proposed RCT design cannot provide a truly realist understanding. Not only does the proposed realist RCT design not deal with the RCT’s inherent inability to “unpack” complex interventions, it also does not enable the identification of the dynamic interplay among the intervention, actors, context, mechanisms and outcomes, which is at the core of realist research. As a result, the proposed realist RCT design is not, as we understand it, genuinely realist in nature.

UR - http://www.scopus.com/inward/record.url?scp=84977505676&partnerID=8YFLogxK

U2 - 10.1186/s13063-016-1407-0

DO - 10.1186/s13063-016-1407-0

M3 - Editorial

VL - 17

SP - 1

EP - 6

JO - Trials

JF - Trials

SN - 1745-6215

M1 - 313

ER -