Van Belle, S, Wong, G, Westhorp, G et al. (4 more authors) (2016) Can ‘realist’ randomized controlled trials be genuinely realist? Trials, 17. 313. ISSN 1745-6215
Abstract
In this paper, we respond to a paper by Jamal and colleagues published in Trials in October 2015, taking the 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 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 between 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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016 Van Belle et al. Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
Keywords: | randomized controlled trials; realist evaluation; scientific realism; causation |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Education, Social Sciences and Law (Leeds) > School of Sociology and Social Policy (Leeds) |
Funding Information: | Funder Grant number National Inst for Health Research (NIHR) Not Known |
Depositing User: | Symplectic Publications |
Date Deposited: | 19 May 2016 10:22 |
Last Modified: | 07 Oct 2017 05:10 |
Published Version: | https://dx.doi.org/10.1186/s13063-016-1407-0 |
Status: | Published |
Publisher: | BioMed Central |
Identification Number: | 10.1186/s13063-016-1407-0 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:99820 |
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