Although readers must decide for themselves whether my commentary1 “contained numerous inaccuracies” or “called the integrity of the organization into question,” clearly, I disagree with the first point, although one of my references (4) was not a good example of an evaluation study. As for integrity, I agree that SMARTRISK has many good intentions, as the letter from Carol Jardine indicates. However, in view of SMARTRISK's awareness of “the need for evidence-based action,” it seems reasonable to question the lack of readily available, peer-reviewed evaluations of Heroes, its flagship program. Indeed, the basic “risk-taking” message, my overriding concern, begs for evidence that it is not harmful. These expectations seem entirely reasonable given the Research Advisory Committee that has been assembled and the staff committed to this end. These are resources few other organizations have the luxury of devoting to evaluation.
The paragraph regarding SMARTRISK's relations with the Ontario Ministry of Health and Long-Term Care lists activities that may be commendable but that also deserve formal evaluation. If SMARTRISK aims to be in the vanguard of safety groups in Canada, it must use some of the generous funds the ministry gave it to evaluate programs and thereby provide guidance for others. But any evaluation that is not fully shared with others through peer-reviewed publication is of limited value.
The main target of my commentary was not SMARTRISK but the ministry. I was troubled by the ministry giving so much money with so little required by way of justification or assurances of productivity, and apparently without considering the possibility that some of what SMARTRISK does may not have the intended effect.
Barry Pless Professor of Pediatrics, Epidemiology and Biostatistics McGill University Montréal, Que.
Reference
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