23 found
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  1. The New Medical Model: A Renewed Challenge for Biomedicine.Jonathan Fuller - 2017 - Canadian Medical Association Journal 189:E640-1.
    Over the past 25 years, several new “medicines” have come screeching onto health care’s various platforms, including narrative medicine, personalized medicine, precision medicine and person-centred medicine. Philosopher Miriam Solomon calls the first three of these movements different “ways of knowing” or “methods,” and argues that they are each a response to shortcomings of methods that came before them. They should also be understood as reactions to the current dominant model of medicine. In this article, I will describe our dominant model, (...)
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  2. Universal Etiology, Multifactorial Diseases and the Constitutive Model of Disease Classification.Jonathan Fuller - 2018 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 67:8-15.
  3. 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.
  4.  12
    The Myth and Fallacy of Simple Extrapolation in Medicine.Jonathan Fuller - forthcoming - Synthese:1-21.
    Simple extrapolation is the orthodox approach to extrapolating from clinical trials in evidence-based medicine: extrapolate the relative effect size from the trial unless there is a compelling reason not to do so. I argue that this method relies on a myth and a fallacy. The myth of simple extrapolation is the idea that the relative risk is a ‘golden ratio’ that is usually transportable due to some special mathematical or theoretical property. The fallacy of simple extrapolation is an unjustified argument (...)
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  5. The Confounding Question of Confounding Causes in Randomized Trials.Jonathan Fuller - 2019 - British Journal for the Philosophy of Science 70 (3):901-926.
    It is sometimes thought that randomized study group allocation is uniquely proficient at producing comparison groups that are evenly balanced for all confounding causes. Philosophers have argued that in real randomized controlled trials this balance assumption typically fails. But is the balance assumption an important ideal? I run a thought experiment, the CONFOUND study, to answer this question. I then suggest a new account of causal inference in ideal and real comparative group studies that helps clarify the roles of confounding (...)
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  6. Prediction in Epidemiology and Medicine.Jonathan Fuller, Alex Broadbent & Luis J. Flores - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences.
  7. Rhetoric and Argumentation: How Clinical Practice Guidelines Think.Jonathan Fuller - 2013 - Journal of Evaluation in Clinical Practice 19 (3):433-441.
    Introduction: Clinical practice guidelines (CPGs) are an important source of justification for clinical decisions in modern evidence-based practice. Yet, we have given little attention to how they argue their evidence. In particular, how do CPGs argue for treatment with long-term medications that are increasingly prescribed to older patients? Approach and rationale: I selected six disease-specific guidelines recommending treatment with five of the medication classes most commonly prescribed for seniors in Ontario, Canada. I considered the stated aims of these CPGs and (...)
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  8. Meta-Research Evidence for Evaluating Therapies.Jonathan Fuller - 2018 - Philosophy of Science 85 (5):767-780.
    The new field of meta-research investigates industry bias, publication bias, contradictions between studies, and other trends in medical research. I argue that its findings should be used as meta-evidence for evaluating therapies. ‘Meta-evidence’ is evidence about the support that direct ‘first-order evidence’ provides the hypothesis. I consider three objections to my proposal: the irrelevance objection, the screening-off objection, and the underdetermination objection. I argue that meta-research evidence works by rationally revising our confidence in first-order evidence and, consequently, in the hypothesis—typically, (...)
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  9. Rationality and the Generalization of Randomized Controlled Trial Evidence.Jonathan Fuller - 2013 - Journal of Evaluation in Clinical Practice 19 (4):644-647.
    Over the past several decades, we devoted much energy to generating, reviewing and summarizing evidence. We have given far less attention to the issue of how to thoughtfully apply the evidence once we have it. That’s fine if all we care about is that our clinical decisions are evidence-based, but not so good if we also want them to be well-reasoned. Let us not forget that evidence based medicine (EBM) grew out of an interest in making medicine ‘rational’, with the (...)
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  10. Clinical Judgement: Multidisciplinary Perspectives.Benjamin Chin-Yee & Jonathan Fuller - 2018 - Journal of Evaluation in Clinical Practice 24 (3):635-637.
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  11.  26
    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.
    With the ascent of modern epidemiology in the Twentieth Century came a new standard model of prediction in public health and clinical medicine. In this article, we describe the structure of the model. The standard model uses epidemiological measures-most commonly, risk measures-to predict outcomes (prognosis) and effect sizes (treatment) in a patient population that can then be transformed into probabilities for individual patients. In the first step, a risk measure in a study population is generalized or extrapolated to a target (...)
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  12. Diseases, Patients and the Epistemology of Practice: Mapping the Borders of Health, Medicine and Care.Michael Loughlin, Robyn Bluhm, Jonathan Fuller, Stephen Buetow, Benjamin R. Lewis & Brent M. Kious - 2015 - Journal of Evaluation in Clinical Practice 21 (3):357-364.
  13. Book Review. Philosophy of Epidemiology by A. Broadbent. [REVIEW]Jonathan Fuller - 2014 - Journal of Evaluation in Clinical Practice 20 (6):1002-1004.
  14.  20
    Reasoning, Evidence, and Clinical Decision-Making: The Great Debate Moves Forward.Michael Loughlin, Robyn Bluhm, Stephen Buetow, Kirstin Borgerson & Jonathan Fuller - 2017 - Journal of Evaluation in Clinical Practice 23 (5):905-914.
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  15. Logos, Ethos and Pathos in Balance.Jonathan Fuller - 2014 - European Journal for Person Centered Healthcare 2 (1):22-29.
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  16. Philosophy, Medicine and Health Care – Where We Have Come From and Where We Are Going.Michael Loughlin, Robyn Bluhm, Jonathan Fuller, Stephen Buetow, Ross E. G. Upshur, Kirstin Borgerson, Maya J. Goldenberg & Elselijn Kingma - 2014 - Journal of Evaluation in Clinical Practice 20 (6):902-907.
  17.  25
    What Are Chronic Diseases?Jonathan Fuller - 2018 - Synthese 195 (7):3197-3220.
    What kind of a thing are chronic diseases? Are they objects, bundles of signs and symptoms, properties, processes, or fictions? Rather than using concept analysis—the standard approach to disease in the philosophy of medicine—to answer this metaphysical question, I use a bottom-up, inductive approach. I argue that chronic diseases are bodily states or properties—often dispositional, but sometimes categorical. I also investigate the nature of related pathological entities: pathogenesis, etiology, and signs and symptoms. Finally, I defend my view against alternate accounts (...)
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  18. Translating Trial Results in Clinical Practice: The Risk GP Model.Jonathan Fuller & Luis J. Flores - 2016 - Journal of Cardiovascular Translational Research 9:167-168.
  19.  13
    Theory, Experience and Practice.Michael Loughlin, Jonathan Fuller, Robyn Bluhm, Stephen Buetow & Kirstin Borgerson - 2016 - Journal of Evaluation in Clinical Practice 22 (4):459-465.
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  20.  18
    Philosophy of Epidemiology by A. Broadbent. Palgrave Macmillan, Basingstoke, 2013, £55.00, 228 Pp. ISBN 978 0 230 20210 8. [REVIEW]Jonathan Fuller - 2014 - Journal of Evaluation in Clinical Practice 20 (6):1002-1004.
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  21.  1
    Book Forum.Jonathan Fuller - 2020 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 81:101270.
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  22.  1
    Universal Etiology, Multifactorial Diseases and the Constitutive Model of Disease Classification.Jonathan Fuller - 2018 - Studies in History and Philosophy of Biological and Biomedical Sciences 67:8-15.
    In this article, I will reconstruct the monocausal model and argue that modern 'multifactorial diseases' are not monocausal by definition. 'Multifactorial diseases' are instead defined according to a constitutive disease model. On closer analysis, infectious diseases are also defined using the constitutive model rather than the monocausal model. As a result, our classification models alone cannot explain why infectious diseases have a universal etiology while chronic and noncommunicable diseases lack one. The explanation is instead provided by the nineteenth-century germ theorists.
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  23.  29
    Prediction in Epidemiology and Medicine.Jonathan Fuller, Alex Broadbent & Luis J. Flores - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54:45-48.