Editors' Note: Driving Better Health Policy: “It's the Evidence, Stupid”

In this paper, Dr. Baicker argues that researchers need to maintain a separation between their values and their role as health services researchers who generate and interpret evidence. She states that “the role of researchers and policy analysts as evidence generators and translators is fundamentally incompatible with the role of advocate,” although “there is certainly an important role for advocates in our system” (Baicker 2018).

We agree that investigators need to be objective and to employ practices to minimize the potential for bias in how they collect, analyze, and interpret data. Health services researchers also have an ethical obligation to publish the results of their studies regardless of the outcomes and not to be selective in only reporting results that reinforce preconceived notions or self‐interests. But is it realistic or desirable for health services researchers to entirely separate their values and their voices as advocates from their work as investigators? For many health services researchers, it is their values that lead them to ask important questions and to conduct studies that make the invisible visible. Many of those who enter into careers as health services researchers do so because they want to use the findings of investigation to inform constructive change.

If we deny the legitimacy of advocacy, even when it is based on evidence, then do we risk defaulting to the status quo, which we know to be inefficient, sometimes ineffective, and often inequitable? Some “advocates” are paid to advance the interests of specific stakeholders; this role may be incompatible with producing the sort of reasoned and unbiased communication of evidence which Dr. Baicker argues is essential. But researchers who testify on behalf of legislative or regulatory proposals informed by their research expertise—or meet with legislative staff during the bill‐writing process—are also “advocates,” attempting to advance evidence‐based health policy.

We share the author's view that health services researchers need to be mindful of when they are objectively performing research and when they are advocating based on findings from research. The career of Professor Uwe Reinhardt, whose memory was honored in a named lecture that was delivered by Dr. Baicker at the 2018 AcademyHealth Annual Research Meeting, exemplified how these activities can be combined and the benefits that can accrue by doing so.

Supporting information

Appendix SA1: Author Matrix.