Results for 'Evidence-Based Medicine methods'

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  1. Just a Paradigm: Evidence-Based Medicine in Epistemological Context.Miriam Solomon - 2011 - European Journal for Philosophy of Science 1 (3):451-466.
    Evidence-Based Medicine (EBM) developed from the work of clinical epidemiologists at McMaster University and Oxford University in the 1970s and 1980s and self-consciously presented itself as a "new paradigm" called "evidence-based medicine" in the early 1990s. The techniques of the randomized controlled trial, systematic review and meta-analysis have produced an extensive and powerful body of research. They have also generated a critical literature that raises general concerns about its methods. This paper is a (...)
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  2.  32
    Evidence-Based Medicine and Women: Do the Principles and Practice of EBM Further Women's Health?Wendy Rogers - 2004 - Bioethics 18 (1):50-71.
    Clinicians and policy makers the world over are embracing evidence-based medicine. The promise of EBM is to use summaries of research evidence to determine which healthcare interventions are effective and which are not, so that patients may benefit from effective interventions and be protected from useless or harmful ones. EBM provides an ostensibly rational and objective means of deciding whether or not an intervention should be provided on the basis of its effectiveness, in theory leading to (...)
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  3.  29
    Evidence-Based Medicine and Progress in the Medical Sciences.Leen De Vreese - 2011 - Journal of Evaluation in Clinical Practice 17 (5):852-856.
    The question what scientific progress means for a particular domain such as medicine seems importantly different from the question what scientific progress is in general. While the latter question received ample treatment in the philosophical literature, the former question is hardly discussed. I argue that it is nonetheless important to think about this question in view of the methodological choices we make. I raise specific questions that should be tackled regarding scientific progress in the medical sciences and demonstrate their (...)
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  4.  67
    The Importance of Values in Evidence-Based Medicine.Michael P. Kelly, Iona Heath, Jeremy Howick & Trisha Greenhalgh - 2015 - BMC Medical Ethics 16 (1):69.
    Evidence-based medicine has always required integration of patient values with ‘best’ clinical evidence. It is widely recognized that scientific practices and discoveries, including those of EBM, are value-laden. But to date, the science of EBM has focused primarily on methods for reducing bias in the evidence, while the role of values in the different aspects of the EBM process has been almost completely ignored.
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  5.  23
    The Process of Evidence-Based Medicine and the Search for Meaning.Rakesh Biswas, Shashikiran Umakanth, Joachim Strumberg, Carmel M. Martin, Manjunath Hande & Jagbir S. Nagra - 2007 - Journal of Evaluation in Clinical Practice 13 (4):529-532.
    BACKGROUND AND RATIONALE: Evidence based medicine is the present backbone of rational and objective, modern medical problem solving and is a meeting ground for quantitative and qualitative researchers alike as it culminates into applying the fruits of clinical research to the individual patient. A systematic enquiry into the evolving paradigms in EBM is a need of the hour. AIMS AND METHODS: A qualitative enquiry examining the impact of different methodologies in EBM and their role in generating (...)
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  6. Philosophical Controversies in the Evaluation of Medical Treatments : With a Focus on the Evidential Roles of Randomization and Mechanisms in Evidence-Based Medicine.Alexander Mebius - 2015 - Dissertation, KTH Royal Institute of Technology
    This thesis examines philosophical controversies surrounding the evaluation of medical treatments, with a focus on the evidential roles of randomised trials and mechanisms in Evidence-Based Medicine. Current 'best practice' usually involves excluding non-randomised trial evidence from systematic reviews in cases where randomised trials are available for inclusion in the reviews. The first paper challenges this practice and evaluates whether adding of evidence from non-randomised trials might improve the quality and precision of some systematic reviews. The (...)
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  7.  8
    Quantum Theory Methods as a Possible Alternative for the Double-Blind Gold Standard of Evidence-Based Medicine: Outlining a New Research Program.Tomas Veloz, Rembrandt Sprundel, Sandro Sozzo, Massimiliano Bianchi, Suzette Geriente, Lester Beltran & Diederik Aerts - 2019 - Foundations of Science 24 (2):217-225.
    We motivate the possibility of using notions and methods derived from quantum physics, and more specifically from the research field known as ‘quantum cognition’, to optimally model different situations in the field of medicine, its decision-making processes and ensuing practices, particularly in relation to chronic and rare diseases. This also as a way to devise alternative approaches to the generally adopted double-blind gold standard.
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  8.  24
    ‘What the Patient Wants’: An Investigation of the Methods of Ascertaining Patient Values in EvidenceBased Medicine and Values‐Based Practice.Sarah Wieten - 2018 - Journal of Evaluation in Clinical Practice 24 (1):8-12.
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  9.  16
    Lost in Translation: Bibliotherapy and Evidence-Based Medicine[REVIEW]Deborah Dysart-Gale - 2008 - Journal of Medical Humanities 29 (1):33-43.
    Evidence-based medicine’s (EBM) quantitative methodologies reflect medical science’s long-standing mistrust of the imprecision and subjectivity of ordinary descriptive language. However, EBM’s attempts to replace subjectivity with precise empirical methods are problematic when clinicians must negotiate between scientific medicine and patients’ experience. This problem is evident in the case of bibliotherapy (patient reading as treatment modality), a practice widespread despite its reliance on anecdotal evidence. While EBM purports to replace such flawed practice with reliable (...)-based methods, this essay argues that its aversion to subjective language prevents EBM from effectively evaluating bibliotherapy or making it amenable to clinical and research governance. (shrink)
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  10.  9
    Introduction to the Symposium: What Evidence Based Medicine is and What It is Not.A. Liberati - 2004 - Journal of Medical Ethics 30 (2):120-121.
    Evidence based medicine has much to offer, but a great deal remains to be done to create a better understanding of what it can and cannot do.The term EBM , as we use it nowadays, was introduced in 1992 by the same group of people who, years before, founded the discipline called “Clinical epidemiology” .1 CE stemmed essentially from the idea of adapting and expanding epidemiological methods to medical and health care decision making; CE was in (...)
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  11. Evidence Based or Person Centered? An Ontological Debate.Rani Lill Anjum - 2016 - European Journal for Person Centered Healthcare 4 (2):421-429.
    Evidence based medicine (EBM) is under critical debate, and person centered healthcare (PCH) has been proposed as an improvement. But is PCH offered as a supplement or as a replacement of EBM? Prima facie PCH only concerns the practice of medicine, while the contended features of EBM also include methods and medical model. I here argue that there are good philosophical reasons to see PCH as a radical alternative to the existing medical paradigm of EBM, (...)
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  12.  6
    Quantum Theory Methods as a Possible Alternative for the Double-Blind Gold Standard of Evidence-Based Medicine: Outlining a New Research Program.Diederik Aerts, Lester Beltran, Suzette Geriente, Massimiliano Sassoli de Bianchi, Sandro Sozzo, Rembrandt Van Sprundel & Tomas Veloz - 2019 - Foundations of Science 24 (2):217-225.
    We motivate the possibility of using notions and methods derived from quantum physics, and more specifically from the research field known as ‘quantum cognition’, to optimally model different situations in the field of medicine, its decision-making processes and ensuing practices, particularly in relation to chronic and rare diseases. This also as a way to devise alternative approaches to the generally adopted double-blind gold standard.
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  13.  33
    Evidence-Based Ethics? On Evidence-Based Practice and The.Maya J. Goldenberg - 2005 - BMC Medical Ethics 6 (1):11.
    BackgroundThe increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics.DiscussionThe recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the (...)
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  14.  61
    Evidence-Based Ethics? On Evidence-Based Practice and the "Empirical Turn" From Normative Bioethics.Maya J. Goldenberg - 2005 - BMC Medical Ethics 6 (1):1-9.
    Background The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics. Discussion The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a (...)
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  15.  21
    Evidence-Based Ethics – What It Should Be and What It Shouldn't.Daniel Strech - 2008 - BMC Medical Ethics 9 (1):16-.
    BackgroundThe concept of evidence-based medicine has strongly influenced the appraisal and application of empirical information in health care decision-making. One principal characteristic of this concept is the distinction between "evidence" in the sense of high-quality empirical information on the one hand and rather low-quality empirical information on the other hand. In the last 5 to 10 years an increasing number of articles published in international journals have made use of the term "evidence-based ethics", making (...)
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  16. Causation and Evidence-Based Practive - an Ontological Review.Roger Kerry, Thor Eirik Eriksen, Svein Anders Noer Lie, Stephen D. Mumford & Rani Lill Anjum - 2012 - Journal of Evaluation in Clinical Practice 18 (5):1006-1012.
    We claim that if a complete philosophy of evidence-based practice is intended, then attention to the nature of causation in health science is necessary. We identify how health science currently conceptualises causation by the way it prioritises some research methods over others. We then show how the current understanding of what causation is serves to constrain scientific progress. An alternative account of causation is offered. This is one of dispositionalism. We claim that by understanding causation from a (...)
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  17. Corroborating EvidenceBased Medicine.Alexander Mebius - 2014 - Journal of Evaluation in Clinical Practice 20 (6):915-920.
    Proponents of evidence-based medicine have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and (...)
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  18.  22
    ‘We Hold These Truths to Be Self-Evident’: Deconstructing ‘Evidence-Based’ Medical Practice.Ignaas Devisch & Stuart J. Murray - 2009 - Journal of Evaluation in Clinical Practice 15 (6):950-964.
    Rationale, aims and objectives : Evidence-based medicine (EBM) claims to be based on 'evidence', rather than 'intuition'. However, EBM's fundamental distinction between quantitative 'evidence' and qualitative 'intuition' is not self-evident. The meaning of 'evidence' is unclear and no studies of quality exist to demonstrate the superiority of EBM in health care settings. This paper argues that, despite itself, EBM holds out only the illusion of conclusive scientific rigour for clinical decision making, and that (...)
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  19.  86
    EvidenceBased Medicine Can’T Be….Adam La Caze - 2008 - Social Epistemology 22 (4):353 – 370.
    Evidence-based medicine (EBM) puts forward a hierarchy of evidence for informing therapeutic decisions. An unambiguous interpretation of how to apply EBM's hierarchy has not been provided in the clinical literature. However, as much as an interpretation is provided proponents suggest a categorical interpretation. The categorical interpretation holds that all the results of randomised trials always trump evidence from lower down the hierarchy when it comes to informing therapeutic decisions. Most of the critical replies to EBM (...)
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  20. The Philosophy of Evidence-Based Medicine.Jeremy Howick - 2011 - Wiley-Blackwell, Bmj Books.
    The philosophy of evidence-based medicine -- What is EBM? -- What is good evidence for a clinical decision? -- Ruling out plausible rival hypotheses and confounding factors : a method -- Resolving the paradox of effectiveness : when do observational studies offer the same degree of evidential support as randomized trials? -- Questioning double blinding as a universal methodological virtue of clinical trials : resolving the Philip's paradox -- Placebo controls : problematic and misleading baseline measures (...)
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  21.  34
    Evidence-Based Medicine, Case-Based Medicine; Scientific Medicine, Quasi-Scientific Medicine. Commentary on Tonelli (2006), Integrating Evidence Into Clinical Practice: An Alternative to Evidence-Based Approaches. Journal of Evaluation in Clinical Practic.Olli S. Miettinen - 2006 - Journal of Evaluation in Clinical Practice 12 (3):260-264.
    In this issue of Journal of Evaluation in Clinical Practice, Tonelli criticizes the ‘philosophy’ of the evidencebased medicine (EBM) movement and advocates a ‘case‐based’ or ‘casuistic’ alternative to EBM – I shall call this case‐based medicine, CBM. -/- Here, I summarize Tonelli’s article, comment on it critically, and then proceed to advocate commitment to knowledge‐based medicine instead. More specifically, I advocate commitment to scientific medicine and to its precursor, quasi‐scientific medicine (...)
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  22.  27
    EvidenceBased Medicine in General Practice: Beliefs and Barriers Among Australian GPs.Jane M. Young & Jeanette E. Ward - 2001 - Journal of Evaluation in Clinical Practice 7 (2):201-210.
  23. What Evidence in Evidence-Based Medicine?John Worrall - 2002 - Proceedings of the Philosophy of Science Association 2002 (3):S316-S330.
    Evidence-Based Medicine is a relatively new movement that seeks to put clinical med- icine on a firmer scientific footing. I take it as uncontroversial that medical practice should be based on best evidence-the interesting questions concern the details. This paper tries to move towards a coherent and unified account of best evidence in medicine, by exploring in particular the EBM position on RCTs (randomized controlled trials).
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  24.  7
    EvidenceBased Medicine—Not a Panacea for the Problems of a Complex Adaptive World.Joachim P. Sturmberg - 2019 - Journal of Evaluation in Clinical Practice 25 (5):706-716.
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  25.  55
    Evidence-Based Medicine and Power Shifts in Health Care Systems.Rein Vos, Rob Houtepen & Klasien Horstman - 2002 - Health Care Analysis 10 (3):319-328.
    It is important and urgent to question therelationship between evidence-based medicineand power shifts in health care systems.Although definitions of EBM are phrased as ascientific approach to medicine, EBM is anormative concept: it aims to improve medicineand health care. Both proponents and opponentsuse a normative concept. More particularly,they provide particular views on positions,responsibilities, possibilities, norms andrelationships between professionals, patientgroups, governments and other parties in healthcare and society. From this perspective, wewant to analyse the role of EBM in modernwestern (...)
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  26.  32
    What Evidence in EvidenceBased Medicine?John Worrall - 2002 - Philosophy of Science 69 (S3):S316-S330.
    Evidence-Based Medicine is a relatively new movement that seeks to put clinical medicine on a firmer scientific footing. I take it as uncontroversial that medical practice should be based on best evidence—the interesting questions concern the details. This paper tries to move towards a coherent and unified account of best evidence in medicine, by exploring in particular the EBM position on RCTs.
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  27.  91
    Evidence-Based Medicine Must Be ..A. La Caze - 2009 - Journal of Medicine and Philosophy 34 (5):509-527.
    Proponents of evidence-based medicine (EBM) provide the “hierarchy of evidence” as a criterion for judging the reliability of therapeutic decisions. EBM's hierarchy places randomized interventional studies (and systematic reviews of such studies) higher in the hierarchy than observational studies, unsystematic clinical experience, and basic science. Recent philosophical work has questioned whether EBM's special emphasis on evidence from randomized interventional studies can be justified. Following the critical literature, and in particular the work of John Worrall, I (...)
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  28.  43
    Evidence-Based Medicine: Requiescat in Pace? A Commentary on Djulbegovic, B., Guyatt, G. H. & Ashcroft, R. E. (2009)Cancer Control, 16, 158-168. [REVIEW]Andrew Miles - 2009 - Journal of Evaluation in Clinical Practice 15 (6):924-929.
  29.  21
    Evidence Based Medicine and Justice: A Framework for Looking at the Impact of EBM Upon Vulnerable or Disadvantaged Groups.W. A. Rogers - 2004 - Journal of Medical Ethics 30 (2):141-145.
    This article examines the implicit promises of fairness in evidence based medicine , namely to avoid discrimination through objective processes, and to distribute effective treatments fairly. The relationship between EBM and vulnerable groups is examined. Several aspects of EBM are explored: the way evidence is created , and the way evidence is applied in clinical care and health policy. This analysis suggests that EBM turns our attention away from social and cultural factors that influence health (...)
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  30.  47
    The EvidenceBased Medicine Model of Clinical Practice: Scientific Teaching or Belief‐Based Preaching?Cathy Charles, Amiram Gafni & Emily Freeman - 2011 - Journal of Evaluation in Clinical Practice 17 (4):597-605.
  31.  5
    Has Evidence-Based Medicine Ever Been Modern? A Latour-Inspired Understanding of a Changing EBM.Sietse Wieringa, Eivind Engebretsen, Kristin Heggen & Trish Greenhalgh - 2017 - Journal of Evaluation in Clinical Practice 23 (5):964-970.
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  32. From Evidence-Based Medicine to Marketing-Based Medicine: Evidence From Internal Industry Documents. [REVIEW]Glen I. Spielmans & Peter I. Parry - 2010 - Journal of Bioethical Inquiry 7 (1):13-29.
    While much excitement has been generated surrounding evidence-based medicine, internal documents from the pharmaceutical industry suggest that the publicly available evidence base may not accurately represent the underlying data regarding its products. The industry and its associated medical communication firms state that publications in the medical literature primarily serve marketing interests. Suppression and spinning of negative data and ghostwriting have emerged as tools to help manage medical journal publications to best suit product sales, while disease mongering (...)
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  33. The Ethics of Alpha: Reflections on Statistics, Evidence and Values in Medicine.R. E. G. Upshur - 2001 - Theoretical Medicine and Bioethics 22 (6):565-576.
    As health care embraces the tenets of evidence-based medicine it is important to ask questions about how evidence is produced and interpreted. This essay explores normative dimensions of evidence production, particularly around issues of setting the tolerable level of uncertainty of results. Four specific aspects are explored: what health care providers know about statistics, why alpha levels have been set at 0.05, the role of randomization in the generation of sufficient grounds of belief, and the (...)
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  34. Mechanisms and the Evidence Hierarchy.Brendan Clarke, Donald Gillies, Phyllis Illari, Federica Russo & Jon Williamson - 2014 - Topoi 33 (2):339-360.
    Evidence-based medicine (EBM) makes use of explicit procedures for grading evidence for causal claims. Normally, these procedures categorise evidence of correlation produced by statistical trials as better evidence for a causal claim than evidence of mechanisms produced by other methods. We argue, in contrast, that evidence of mechanisms needs to be viewed as complementary to, rather than inferior to, evidence of correlation. In this paper we first set out the case (...)
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  35.  19
    EvidenceBased Medicine, Guidelines, Personality Types, Relatives and Absolutes.Philip D. Welsby - 2002 - Journal of Evaluation in Clinical Practice 8 (2):163-166.
  36.  28
    EvidenceBased Medicine and Epistemological Imperialism: Narrowing the Divide Between Evidence and Illness.Helen Crowther, Wendy Lipworth & Ian Kerridge - 2011 - Journal of Evaluation in Clinical Practice 17 (5):868-872.
    Evidence-based medicine has been rapidly and widely adopted because it claims to provide a method for determining the safety and efficacy of medical therapies and public health interventions more generally. However, as others have noted, EBM may be riven through with cultural bias, both in the generation of evidence and in its translation. We suggest that technological and scientific advances in medicine accentuate and entrench these cultural biases, to the extent that they may invalidate the (...)
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  37.  9
    EvidenceBased Medicine as Science.Joseph Vere & Barry Gibson - 2019 - Journal of Evaluation in Clinical Practice 25 (6):997-1002.
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  38. How EvidenceBased Medicine is Failing Due to Biased Trials and Selective Publication.Susanna Every‐Palmer & Jeremy Howick - 2014 - Journal of Evaluation in Clinical Practice 20 (6):908-914.
  39.  25
    EvidenceBased Medicine Beyond the Bedside: Keeping an Eye on Context.Jon C. Tilburt - 2008 - Journal of Evaluation in Clinical Practice 14 (5):721-725.
  40.  8
    EvidenceBased Medicine. The Good the Bad and the Ugly. A Clinician's Perspective.Kumanan Wilson - 2010 - Journal of Evaluation in Clinical Practice 16 (2):398-400.
  41.  36
    EvidenceBased Medicine Training in a Resource‐Poor Country, the Importance of Leveraging Personal and Institutional Relationships.Cristina Tomatis, Claudia Taramona, Emiliana Rizo-Patrón, Fiorela Hernández, Patricia Rodríguez, Alejandro Piscoya, Elsa Gonzales, Eduardo Gotuzzo, Gustavo Heudebert, Robert M. Centor & Carlos A. Estrada - 2011 - Journal of Evaluation in Clinical Practice 17 (4):644-650.
  42.  22
    Evidence-Based Medicine and Quality of Care.Donna Dickenson & Paolo Vineis - 2002 - Health Care Analysis 10 (3):243-259.
    In this paper we set out to examine thearguments for and against the claim thatEvidence-Based Medicine (EBM) will improve thequality of care. In particular, we examine thefollowing issues.
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  43.  29
    Evidence Based Medicine Guidelines: A Solution to Rationing or Politics Disguised as Science?S. I. Saarni - 2004 - Journal of Medical Ethics 30 (2):171-175.
    Evidence based medicine” is often seen as a scientific tool for quality improvement, even though its application requires the combination of scientific facts with value judgments and the costing of different treatments. How this is done depends on whether we approach the problem from the perspective of individual patients, doctors, or public health administrators. Evidence based medicine exerts a fundamental influence on certain key aspects of medical professionalism. Since, when clinical practice guidelines are created, (...)
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  44. On Evidence and Evidence-Based Medicine: Lessons From the Philosophy of Science.Maya J. Goldenberg - 2006 - Social Science and Medicine 62 (11):2621-2632.
    The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the (...)
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  45.  37
    EvidenceBased Medicine: The Need for a New Definition.S. Buetow & T. Kenealy - 2000 - Journal of Evaluation in Clinical Practice 6 (2):85-92.
  46.  31
    EvidenceBased Medicine: Why All the Fuss? This is Why.A. Miles, P. Bentley, A. Polychronis & J. Grey - 1997 - Journal of Evaluation in Clinical Practice 3 (2):83-86.
  47.  44
    Evidence-Based Medicine and Modernism: Still Better Than the Alternatives.Peter Zachar - 2012 - Philosophy, Psychiatry, and Psychology 19 (4):313-316.
    Thomas, Bracken, and Timimi (2012) make an important contribution in critiquing the extent to which the profession of psychiatry can be so bureaucratic that patients are treated as problems to be solved in an ‘efficient’ assembly line fashion rather than as individual persons. The trouble with bureaucracies is that they promote a cold and impersonal accounting approach in which critical reflection on purposes is circumvented by decision-making algorithms (Zachar and Bartlett 2009). Psychotherapy treatment manuals definitely satisfy the bureaucratic instinct, and (...)
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  48.  6
    EvidenceBased Medicine: A Cornerstone for Clinical Care but Not for Quality Improvement.Shawn Mondoux & Kaveh G. Shojania - 2019 - Journal of Evaluation in Clinical Practice 25 (3):363-368.
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  49.  12
    Is Evidence-Based Medicine About Democratizing Medical Practice?Keld Thorgaard - 2014 - Outlines. Critical Practice Studies 15 (1):49-62.
    The authoritarian standpoint in medicine has been under challenge by various groups and researchers since the 1980s. The challenges have been ethical, political and medical, with patient movements at the forefront. Over the past decade, however, a deep challenge has been posed by evidence-based medicine (EBM), which has challenged the entire strategy of medical treatment from the point of view of a self-critical, anti-authoritarian and hereby also (it has been claimed) a more democratic medical practice. Previously, (...)
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  50.  23
    EvidenceBased Medicine: A Kuhnian Perspective of a Transvestite Non‐Theory.Joaquim S. Couto Md - 1998 - Journal of Evaluation in Clinical Practice 4 (4):267-275.
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