23 found
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  1. 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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  2.  29
    What are the COVID-19 models modeling (philosophically speaking)?Jonathan Fuller - 2021 - History and Philosophy of the Life Sciences 43 (2):1-5.
    COVID-19 epidemic models raise important questions for science and philosophy of science. Here I provide a brief preliminary exploration of three: what kinds of predictions do epidemic models make, are they causal models, and how do different kinds of epidemic models differ in terms of what they represent?
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  3.  54
    The myth and fallacy of simple extrapolation in medicine.Jonathan Fuller - 2019 - Synthese 198 (4):2919-2939.
    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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  4. Epidemics from the Population Perspective.Jonathan Fuller - 2022 - Philosophy of Science 89 (2):232-251.
    Many epidemics consist in individuals spreading infection to others. From the population perspective, they also have population characteristics important in modeling, explaining, and intervening in epidemics. I analyze epidemiology’s contemporary population perspective through the example of epidemics by examining two central principles attributed to Geoffrey Rose: a distinction between the causes of cases and the causes of incidence, and between “high-risk” and “population” strategies of prevention. Both principles require revision or clarification to capture the sense in which they describe distinct (...)
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  5.  98
    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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  6. 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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  7. 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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  8.  57
    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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  9. 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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  10. 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.
    Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy ‘at the bedside’? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a broader argument to the effect that ethical questions – about what we should do in any given situation – are (...)
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  11. Epidemiological Evidence: Use at Your ‘Own Risk’?Jonathan Fuller - 2020 - Philosophy of Science 87 (5):1119-1129.
    What meaning does epidemiological evidence have for the individual? In evidence-based medicine, epidemiological evidence measures the patient’s risk of the outcome or the change in risk due to an intervention. The patient’s risk is commonly understood as an individual probability. The problem of understanding epidemiological evidence and risk thus becomes the challenge of interpreting individual patient probabilities. I argue that the patient’s risk is interpreted ontically, as a propensity. After exploring formidable problems with this interpretation in the medical context, I (...)
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  12. 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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  13. 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.
    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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  14. 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.
  15.  13
    Demarcating scientific medicine.Jonathan Fuller - 2024 - Studies in History and Philosophy of Science Part A 106 (C):177-185.
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  16. Logos, ethos and pathos in balance.Jonathan Fuller - 2014 - European Journal for Person Centered Healthcare 2 (1):22-29.
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  17. Translating Trial Results in Clinical Practice: the Risk GP Model.Jonathan Fuller & Luis J. Flores - 2016 - Journal of Cardiovascular Translational Research 9:167-168.
  18.  66
    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.
  19.  24
    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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  20.  24
    Preventive and curative medical interventions.Jonathan Fuller - 2022 - Synthese 200 (2):1-24.
    Medical interventions that cure or prevent medical conditions are central to medicine; and thus, understanding them is central to our understanding of medicine. My purpose in this paper is to explore the conceptual foundations of medicine by providing a singular analysis of the concept of a ‘preventive or curative medical intervention’. Borrowing a general account of prevention from Phil Dowe, I provide an analysis of prevention, cure, risk reduction, and a preventive or curative intervention, before turning to preventive and curative (...)
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  21. Demarcating and Judging Medicine: Review of Broadbent’s Philosophy of Medicine. [REVIEW]Jonathan Fuller - 2021 - Philosophy of Science 88 (2):370-376.
  22. Book Review. Philosophy of Epidemiology by A. Broadbent. [REVIEW]Jonathan Fuller - 2014 - Journal of Evaluation in Clinical Practice 20 (6):1002-1004.
  23. Medical Nihilism by Jacob Stegenga: What is the right dose? [REVIEW]Jonathan Fuller - 2020 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 81.