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This article tests several hypotheses about distributive politics by studying the distribution of federal spending across US states over the period 1978-2002. It improves on previous work by using survey data to measure the share of voters in each state that are Democrats, Republicans and Independents, or liberals, conservatives and moderates. No evidence is found that the allocation of federal spending to the states is distorted by strategic manipulation to win electoral support. States with many swing voters are not advantaged compared to states with more loyal voters, and 'battleground states' are not advantaged compared to other states. Spending appears to have little or no effect on voters' choices, while partisanship and ideology have large effects. Adapted from the source document.

Does control of patronage jobs significantly increase a political party's chances of winning elections in U.S. states? We employ a differences-in-differences design, exploiting the considerable variation in the dates that different states adopted civil service reforms. Our evidence suggests that political parties in U.S. states were able to use state-level patronage to increase the probability of maintaining control of state legislatures and statewide elective offices. We also find that an "entrenched" party, in power for a longer time, can use patronage more effectively. We consider several alternative hypotheses that might plausibly account for the patterns in the data, but find no evidence to support them.

We develop a model of intraparty candidate selection under partisan electoral competition and voter uncertainty. Candidates for office belong to parties, which are factions of ideologically similar candidates. Each party's candidate for a general election can be selected either by a "centralized" mechanism that effectively randomizes over possible candidates or by voters in a primary election. The electorate cares about ideology and valence, and both primary and general elections may reveal candidate valences. Our main theoretical result is that while primaries raise the expected quality of a party's candidates, they may hurt the ex ante preferred party in a competitive electorate by increasing the chances of revealing the opposing party's candidates as superior. Thus, primaries are adopted in relatively extreme districts where a clear favorite party exists. An empirical analysis of the adoption of direct primaries and the competitiveness of primary elections across U.S. states supports these predictions. Adapted from the source document.

PURPOSE OF REVIEW: Real-world data (RWD) applications in healthcare that support learning health systems and pragmatic clinical trials are gaining momentum, largely due to legislation supporting real-world evidence (RWE) for drug approvals. Clinical notes are thought to be the cornerstone of RWD applications, particularly for conditions with limited effective treatments, extrapolation of treatments from other conditions, or heterogenous disease biology and clinical phenotypes. RECENT FINDINGS: Here, we discuss current issues in applying RWD captured at the point-of-care and provide a framework for clinicians to engage in RWD collection. To achieve clinically meaningful results, RWD must be reliably captured using consistent terminology in the description of our patients. SUMMARY: RWD complements traditional clinical trials and research by informing the generalizability of results, generating new hypotheses, and creating a large data network for scientific discovery. Effective clinician engagement in the development of RWD applications is necessary for continued progress in the field.