Clinical intuition versus statistics: Different modes of tacit knowledge in clinical epidemiology and evidence-based medicine

Theoretical Medicine and Bioethics 30 (3):181-198 (2009)
Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-based medicine movement has not succeeded in shaking off an epistemological critique derived from the experiential or tacit dimensions of clinical reasoning about particular individuals. This critique claims that the evidence-based medicine model does not take account of tacit knowing as developed by the philosopher Michael Polanyi. However, the epistemology of evidence-based medicine is premised on the elimination of the tacit dimension from clinical judgment. This is demonstrated through analyzing the dichotomy between clinical and statistical intuition in evidence-based medicine’s epistemology of clinical reasoning. I argue that clinical epidemiology presents a more nuanced epistemological model for the application of statistical epidemiology to the clinical context. Polanyi’s theory of tacit knowing is compatible with the model of clinical reasoning associated with clinical epidemiology, but not evidence-based medicine.
Keywords Clinical reasoning  Clinical epidemiology  Evidence-based medicine  Epistemology  Intuition  Randomization  Statistics  Tacit knowing
Categories (categorize this paper)
DOI 10.1007/s11017-009-9106-4
 Save to my reading list
Follow the author(s)
My bibliography
Export citation
Find it on Scholar
Edit this record
Mark as duplicate
Revision history Request removal from index
Download options
PhilPapers Archive

Upload a copy of this paper     Check publisher's policy on self-archival     Papers currently archived: 16,667
External links
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library
References found in this work BETA
Stephen G. Henry (2006). Recognizing Tacit Knowledge in Medical Epistemology. Theoretical Medicine and Bioethics 27 (3):187--213.

View all 11 references / Add more references

Citations of this work BETA

Add more citations

Similar books and articles

Monthly downloads

Added to index


Total downloads

100 ( #31,243 of 1,726,249 )

Recent downloads (6 months)

11 ( #61,095 of 1,726,249 )

How can I increase my downloads?

My notes
Sign in to use this feature

Start a new thread
There  are no threads in this forum
Nothing in this forum yet.