Is scientific knowledge useful for decision making?

1
Is scientific knowledge useful for decision
making?

• CRICS 5
• La Habana, April 2001

2
Why this question?

• Because although decision makers are requesting
  more and more that researchers be their advisors,
  nevertheless this relation is complex, made of
  unsatisfied expectations on both sides and
  misundertsanding
• This is particularly true in public health.

3
The right question

• How can we improve the effectiveness of the link
  between research and decision making?

4
Why public health?

• Because it has become a domain of increasing
  demand from decision makers
• Because, by definition, public health research
  has a vocation to be applicable research.
• Public health research deals with the
  functionning of social systems and their impact
  on the health of populations its outcomes are of
  interest only if they translate in policies

5
What is wrong between decision makers and
researchers?

• The initial quid pro quo
• Decision making is about dealing with
  uncertainty. Decision makers secret hope is that
  research will bring certainty, whereas in most
  cases research brings plausible predictions.
• On the other hand, researchers are enclined (its
  their job) to think that science is the only way
  to produce truth, but science only produces
  partial answers to specific questions.

6
Bounded rationality

• Researchers tend to think that they are rational,
  and decision makers caught in a web of
  intertwined interests at the best, decision
  makers have the rationality of their
  constituencies.
• But scientists must not forget that they are also
  acting under bounded rationality they have
  access to limited resources, and they choose
  their research issues according to competition
  with other scientists.

7
Prediction and action

• Research as said before will help make plausible
  predictions on the evolution of specific systems,
  according to different scenarios
• But the role of the decision maker is to make
  some of those predictions come true.

8
The context of decision

• Often, the problem at study is one of many in the
  decision makers agenda. This may not be well
  perceived by the researcher, but will definitely
  have an influence on the way the decision maker
  will consider his/her work. The decision maker
  will consider a nexus of intertwined decisions,
  not only one.

9
The context of decision

• Decision makers have to anticipate the impact and
  the reaction of their different constituencies to
  the problem at study
• The researcher oftent does not integrate this
  aspect both for ethical and methodological
  issues.

10
Deadlines

• Decision makers have their own agenda, and may
  not be able to wait for research results
• Scientists are always asking for time and money!
• The clocks are not the same.

11
The time to learn

• To be understood, research needs to convince
• Decision makers
• But also, all the actors that are relevant to the
  issue of concern by the policy.
• It takes time, and persuasion often it is not
  useful to be right to early, people are not ready
  to hear the message from research

12
Attitude towards risk and uncertainty

• Researchers think that rational decision making
  under uncertainty should lead to a Von Neuman
  Morgenstern decision rule of maximization of the
  expected benefits
• There is more and more empirical evidence
  suggesting that people are actually biasing
  probabilities of outcomes according to the value
  they give to each consequence.

13
Accountability

• The advisors are not the payors.Researchers
  should accept that since they are not responsible
  for decision making, they should allow decision
  makers not to follow their advice.

14
The remedies

• There is a need for special skills, or for a
  function to exist between research and decision
  makers, to mediate their interaction.
• What skills? What tasks?

15
Uncertainty

• When there is uncertainty, suggest decisions that
  allows to produce knowledge on the areas of
  uncertainty
• Assessment during implementation
• Point out to areas of strong irreversibility

16
Translation

• From decision to research
• Translation means to explain the decision
  context, so as to adapt the research agenda and
  anticipate on the reactions of different
  constituencies.
• From research to decision
• Translation means to explicit to the decision
  maker the way his or her demand has been
  transformed.

17
Strategic thinking

• To help the decision maker, the researcher must
  become a strategist, understand the context of
  decision
• Identify the relevant actors, their motivations
  and their potential for action
• Identify the need for communication, to find
  support.

18
Deadlines

• Produce only synthesis of existing research
• Accept the idea that there are favourable times
  to pass on messages
• Learn how to diffuse knowledge so as to gain
  allies

19
Ethics

• Can a researcher become an actor in the decision
  process? Is it ethical?
• Yes, if the knowledge resource he/she represents
  is equitably distributed among actors
• Yes, if researchers remember that they also have
  their own prejudices when designing a research