A couple of the nasties lurking in evidence-based medicine
Social Epistemology 22 (4):333 – 352 (2008)
| Abstract | The Evidence-Based Medicine (EBM) movement is an ideological force in health research and health policy which asks for allegiance to two types of methodological doctrine. The first is the highly quotable motherhood statement: for example, that we should make conscientious, explicit and judicious use of current best evidence (paraphrasing Sackett). The second type of doctrine, vastly more specific and in practice more important, is the detailed methodology of design and analysis of experiments. This type of detailed methodological doctrine tends to be simplified by commentators but followed to the letter by practitioners. A number of interestingly dumb claims have become entrenched in prominent versions of these more specific methodological doctrines. I look at just a couple of example claims, namely: Any randomised controlled trial (RCT) gives us better evidence than any other study. Confidence intervals are always useful summaries of at least part of the evidence an experiment gives us about a hypothesis. To offer a positive doctrine which might move us past the current conflict of micro-theories of evidence, I propose a mild methodological pluralism: in any local context in which none of a variety of scientific methodologies is clearly and uncontentiously right, researchers should not be discouraged from using any methodology for which they can provide a good argument | |||||||||
| Keywords | No keywords specified (fix it) | |||||||||
| Categories | ||||||||||
| ISBN(s) | 0269-1728 | |||||||||
| Options |
|
|||||||||
Download options| PhilPapers Archive |
Upload a copy of this paper Check publisher's policy on self-archival Papers currently archived: 5,705 |
| External links |
 |
| Through your library | Configure |
Similar books and articlesMaya J. Goldenberg (2006). On Evidence and Evidence-Based Medicine: Lessons From the Philosophy of Science. Social Science and Medicine 62 (11):2621-2632.
Mona Gupta (2007). Does Evidence-Based Medicine Apply to Psychiatry? Theoretical Medicine and Bioethics 28 (2):103.
A. la Caze (2009). Evidence-Based Medicine Must Be .. Journal of Medicine and Philosophy 34 (5):509-527.
Jeremy Howick (2011). The Philosophy of Evidence-Based Medicine. Wiley-Blackwell, Bmj Books.
Ron Morstyn (2010). How the Philosophy of Merleau- Ponty Can Help Us Understand the Gulf Between Clinical Experience and the Doctrine of Evidence-Based Psychotherapy. Australasian Psychiatry 18 ( 3):221–225.
Maya J. Goldenberg (2009). Iconoclast or Creed? Objectivism, Pragmatism, and the Hierarchy of Evidence. Perspectives in Biology and Medicine 52 (2):168-187.
Brian Hazelton Walsh (2010). The Spatialisation of Disease: Foucualt and Evidence-Based Medicine (Ebm). Journal of Bioethical Inquiry 7 (1):31-42.
Erica Zarkovich & R. E. G. Upshur (2002). The Virtues of Evidence. Theoretical Medicine and Bioethics 23 (4-5).
Analytics
Monthly downloads |
Added to index2009-02-01Total downloads19 ( #64,434 of 549,549 )Recent downloads (6 months)1 ( #63,397 of 549,549 )How can I increase my downloads? |
My notes
Discussion
