Authors
Jacob Stegenga
Cambridge University
Abstract
Measuring the effectiveness of medical interventions faces three epistemological challenges: the choice of good measuring instruments, the use of appropriate analytic measures, and the use of a reliable method of extrapolating measures from an experimental context to a more general context. In practice each of these challenges contributes to overestimating the effectiveness of medical interventions. These challenges suggest the need for corrective normative principles. The instruments employed in clinical research should measure patient-relevant and disease-specific parameters, and should not be sensitive to parameters that are only indirectly relevant. Effectiveness always should be measured and reported in absolute terms (using measures such as 'absolute risk reduction'), and only sometimes should effectiveness also be measured and reported in relative terms (using measures such as 'relative risk reduction')-employment of relative measures promotes an informal fallacy akin to the base-rate fallacy, which can be exploited to exaggerate claims of effectiveness. Finally, extrapolating from research settings to clinical settings should more rigorously take into account possible ways in which the intervention in question can fail to be effective in a target population.
Keywords effectiveness  measurement  evidence-based medicine  extrapolation  outcome measures
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DOI 10.1016/j.shpsc.2015.06.003
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References found in this work BETA

The Philosophy of Evidence-Based Medicine.Jeremy Howick - 2011 - Wiley-Blackwell, Bmj Books.
Interpreting Causality in the Health Sciences.Federica Russo & Jon Williamson - 2007 - International Studies in the Philosophy of Science 21 (2):157 – 170.

View all 24 references / Add more references

Citations of this work BETA

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.
Foundations of a Probabilistic Theory of Causal Strength.Jan Sprenger - 2018 - Philosophical Review 127 (3):371-398.
Three Arguments for Absolute Outcome Measures.Jan Sprenger & Jacob Stegenga - 2017 - Philosophy of Science 84 (5):840-852.

View all 16 citations / Add more citations

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