There is growing demand for policy based on rigorous evidence. Many consider the strongest evidence to come from studies that identify causality with high internal validity - such as RCTs - and systematic reviews of these studies. If policies are based strictly on such rigorous evidence there is a risk of bias towards simple, discrete, measurable interventions and away from complex interventions. Rigorous evidence is also better suited to some questions than others. Evaluations may provide stronger conclusions about impact than about the mechanisms, implementation, context, generalisability and scaling of interventions. For these reasons, policy-making does – and should – consider issues for which there is no conclusive evidence. However, there is little guidance as to how and when such inconclusive evidence can be used.
We present a framework for considering inconclusive evidence applied to examples from evidence-based education in low- and middle-income countries. The framework involves a systematic consideration of the estimated costs, benefits and potential harm of a policy, along with the uncertainty in those estimates. This analysis is conducted using standard decision theory and an examination of the utility of policies. We argue that it is rational to pursue a policy with uncertain outcomes if there is a reasonable probability of large positive utility (compared to the cost of the intervention) and a low probability of negative utility. The decision to act under uncertainty is influenced by a number of other considerations including: the potential to improve the evidence base, the urgency of the decision and the analysis of alternative options. The framework also calls for systematic analysis of uncertainty associated with all components of a policy decision. For example, some interventions may have robust evidence of impact but considerable uncertainty associated with the generalisability of the evidence to a new context, or with the scalability of the intervention. We discuss our approach to measuring and reducing uncertainty in policy decisions and its implications for evaluation and research. The overall aim of this work is to make evidence-based decision-making more effective and applicable to a wider range of problems.