a) doing so has not met its objective b) has likely done harm c) has been infiltrated by industry along the way d) other options exist
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Replying to @WeDietitians @GidMK
How do we know “a public policy is working”? .....how much evidence is enough to change it?
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Replying to @WeDietitians @GidMK
There’s a degree of collateral damage with any policy - an unexplored area of epi that doesn’t seem to rate as part of the decision-making. Adverse outcomes may not be mitigated by, say, insisting on Grade B & above - but we won’t know unless “adverse outcomes” are considered
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Replying to @WeDietitians
You can't generate Grade B evidence for many issues. Smoking is a prime example. Can't run an RCT on smoking. What would you propose we do in these situations?
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Replying to @GidMK
As has been said previously on Twitter - critique does not demand solutions. 1. Please stop using comparators 2. ADG have not met their objective 3. Possible objective not achieved for many reasons, one is the poor evidence (& historical lack thereof) it’s based on
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Replying to @WeDietitians
That's a ridiculous response. Arguing that it's a non-perfect basis assumes that there is some perfection to be had. As I've said, this is often not the case, so your suggestion is to stop caring about evidence at all in cases where we cannot generate perfection
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Replying to @GidMK
Gid, please. Soften the emotive. It’s not ridiculous. also note not disagreeing is not by default agreeing. WRT “I agree with not smoking” - I’ve not said I do, but nor have I said I don’t. I asked we don’t compare to other policy on the basis one is essential one is not
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Replying to @WeDietitians @GidMK
From your article: “But they are based on very solid reviews of strong scientific evidence. They may not always be right, but they definitely aren’t wrong.” “Very solid” “strong” “not wrong”? ....this is how you represent GRADE C?
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Replying to @WeDietitians
Indeed. It is also how the NHMRC represents it. Based on a large body of scientific evidence, not just tradition or some such silliness
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Replying to @GidMK
So even after critiquing the evidence you agreed with such a description? Could you point to where the NHMRC described it as such?
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NHMRC guideline documents. Worthwhile mentioning that the ADG are, of course, made up of numerous recommendations with different levels of evidence https://www.nhmrc.gov.au/guidelines-publications/information-guideline-developers/resources-guideline-developers …
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