Authors
Jacob Stegenga
Cambridge University
Abstract
An astonishing volume and diversity of evidence is available for many hypotheses in the biomedical and social sciences. Some of this evidence—usually from randomized controlled trials (RCTs)—is amalgamated by meta-analysis. Despite the ongoing debate regarding whether or not RCTs are the ‘gold-standard’ of evidence, it is usually meta-analysis which is considered the best source of evidence: meta-analysis is thought by many to be the platinum standard of evidence. However, I argue that meta-analysis falls far short of that standard. Different meta-analyses of the same evidence can reach contradictory conclusions. Meta-analysis fails to provide objective grounds for intersubjective assessments of hypotheses because numerous decisions must be made when performing a meta-analysis which allow wide latitude for subjective idiosyncrasies to influence its outcome. I end by suggesting that an older tradition of evidence in medicine—the plurality of reasoning strategies appealed to by the epidemiologist Sir Bradford Hill—is a superior strategy for assessing a large volume and diversity of evidence.
Keywords meta-analysis  RCT  randomized controlled trial  evidence
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DOI 10.1016/j.shpsc.2011.07.003
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References found in this work BETA

Are Rcts the Gold Standard?Nancy Cartwright - 2007 - Biosocieties 1:11-20.
Robustness, Discordance, and Relevance.Jacob Stegenga - 2009 - Philosophy of Science 76 (5):650-661.
What Evidence in Evidence-Based Medicine?John Worrall - 2002 - Proceedings of the Philosophy of Science Association 2002 (3):S316-S330.

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Citations of this work BETA

The Risk GP Model: The Standard Model of Prediction in Medicine.Jonathan Fuller & Luis J. Flores - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54:49-61.
Can the Behavioral Sciences Self-Correct? A Social Epistemic Study.Felipe Romero - 2016 - Studies in History and Philosophy of Science Part A 60:55-69.

View all 40 citations / Add more citations

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