Expérience naturelle

A natural experiment is a study in which individuals (or clusters of individuals) are exposed to the experimental and control conditions that are determined by nature or by other factors outside the control of the investigators. The process governing the exposures arguably resembles random assignment. Thus, natural experiments are observational studies and are not controlled in the traditional sense of a randomized experiment (an intervention study). Natural experiments are most useful when there has been a clearly defined exposure involving a well defined subpopulation (and the absence of exposure in a similar subpopulation) such that changes in outcomes may be plausibly attributed to the exposure. In this sense, the difference between a natural experiment and a non-experimental observational study is that the former includes a comparison of conditions that pave the way for causal inference, but the latter does not. Natural experiments are employed as study designs when controlled experimentation is extremely difficult to implement or unethical, such as in several research areas addressed by epidemiology (like evaluating the health impact of varying degrees of exposure to ionizing radiation in people living near Hiroshima at the time of the atomic blast) and economics (like estimating the economic return on amount of schooling in US adults). One of the best-known early natural experiments was the 1854 Broad Street cholera outbreak in London, England. On 31 August 1854, a major outbreak of cholera struck Soho. Over the next three days, 127 people near Broad Street died. By the end of the outbreak 616 people died. The physician John Snow identified the source of the outbreak as the nearest public water pump, using a map of deaths and illness that revealed a cluster of cases around the pump. In this example, Snow discovered a strong association between the use of the water from the pump, and deaths and illnesses due to cholera.