Authors
Jon Williamson
University of Kent
Daniel Auker-Howlett
University of Kent (PhD)
Abstract
Evidence-based medicine, the dominant approach to assessing the effectiveness of clinical and public health interventions, focuses on the results of association studies. EBM+ is a development of EBM that systematically considers mechanistic studies alongside association studies. In this paper we provide several examples of the importance of mechanistic evidence to coronavirus research. Assessment of combination therapy for MERS highlights the need for systematic assessment of mechanistic evidence. That hypertension is a risk factor for severe disease in the case of SARS-CoV-2 suggests that altering hypertension treatment might alleviate disease, but the mechanisms are complex, and it is essential to consider and evaluate multiple mechanistic hypotheses. To be confident that public health interventions will be effective requires a detailed assessment of social and psychological components of the mechanisms of their action, in addition to mechanisms of disease. In particular, if vaccination programmes are to be effective, they must be carefully tailored to the social context; again, mechanistic evidence is crucial. We conclude that coronavirus research is best situated within the EBM+ evaluation framework.
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DOI 10.1111/jep.13438
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References found in this work BETA

Evidential Proximity, Independence, and the Evaluation of Carcinogenicity.Jon Williamson - 2019 - Journal of Evaluation in Clinical Practice 25 (6):955-961.
Reinforced Reasoning in Medicine.Daniel Auker-Howlett & Michael Wilde - 2019 - Journal of Evaluation in Clinical Practice 26 (2):458-464.

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