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  1. Metabolic Theories of Whipple Disease.Oscar Morice, Mathew Elameer, Mina Arsanious, Helen Stephens, Eleanor Soutter, Thomas Hughes & Brendan Clarke - manuscript
    Whipple disease is a rare, infectious, disease first described from a single case by Whipple in 1907. As well as characterising the clinical and pathological features of the condition, Whipple made two suggestions regarding its aetiology. These were either than the disease was caused by an infectious agent, or that it was of metabolic origin. As the disease is now thought to be caused by infection with the bacterium Tropheryma whipplei, historical reviews of the history of the disease typically mention (...)
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  2. Reliability of Molecular Imaging Diagnostics.Elisabetta Lalumera, Stefano Fanti & Giovanni Boniolo - forthcoming - Synthese:1-17.
    Advanced medical imaging, such as CT, fMRI and PET, has undergone enormous progress in recent years, both in accuracy and utilization. Such techniques often bring with them an illusion of immediacy, the idea that the body and its diseases can be directly inspected. In this paper we target this illusion and address the issue of the reliability of advanced imaging tests as knowledge procedures, taking positron emission tomography in oncology as paradigmatic case study. After individuating a suitable notion of reliability, (...)
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  3. Herding QATs: Quality Assessment Tools for Evidence in Medicine.Jacob Stegenga - forthcoming - In Huneman, Silberstein & Lambert (eds.), Herding QATs: Quality Assessment Tools for Evidence in Medicine.
    Medical scientists employ ‘quality assessment tools’ (QATs) to measure the quality of evidence from clinical studies, especially randomized controlled trials (RCTs). These tools are designed to take into account various methodological details of clinical studies, including randomization, blinding, and other features of studies deemed relevant to minimizing bias and error. There are now dozens available. The various QATs on offer differ widely from each other, and second-order empirical studies show that QATs have low inter-rater reliability and low inter-tool reliability. This (...)
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  4. New Directions in Philosophy of Medicine.Jacob Stegenga, Ashley Kennedy, Serife Tekin, Saana Jukola & Robyn Bluhm - forthcoming - In James Marcum (ed.), Bloomsbury Companion to Contemporary Philosophy of Medicine. Bloomsbury Academic. pp. 343-367.
    The purpose of this chapter is to describe what we see as several important new directions for philosophy of medicine. This recent work (i) takes existing discussions in important and promising new directions, (ii) identifies areas that have not received sufficient and deserved attention to date, and/or (iii) brings together philosophy of medicine with other areas of philosophy (including bioethics, philosophy of psychiatry, and social epistemology). To this end, the next part focuses on what we call the “epistemological turn” in (...)
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  5. Were Lockdowns Justified? A Return to the Facts and Evidence.Philippe van Basshuysen & Lucie White - forthcoming - Kennedy Institute of Ethics Journal.
    Were governments justified in imposing lockdowns to contain the spread of the COVID-19 pandemic? We argue that a convincing answer to this question is to date wanting, by critically analyzing the factual basis of a recent paper, “How Government Leaders Violated Their Epistemic Duties During the SARS-CoV-2 Crisis” (Winsberg et al. 2020). In their paper, Winsberg et al. argue that government leaders did not, at the beginning of the pandemic, meet the epistemic requirements necessitated to impose lockdowns. We focus on (...)
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  6. Shared Decision‐Making and Maternity Care in the Deep Learning Age: Acknowledging and Overcoming Inherited Defeaters.Keith Begley, Cecily Begley & Valerie Smith - 2021 - Journal of Evaluation in Clinical Practice 27 (3):497–503.
    In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds in (...)
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  7. Causal Inference From Noise.Nevin Climenhaga, Lane DesAutels & Grant Ramsey - 2021 - Noûs 55 (1):152-170.
    "Correlation is not causation" is one of the mantras of the sciences—a cautionary warning especially to fields like epidemiology and pharmacology where the seduction of compelling correlations naturally leads to causal hypotheses. The standard view from the epistemology of causation is that to tell whether one correlated variable is causing the other, one needs to intervene on the system—the best sort of intervention being a trial that is both randomized and controlled. In this paper, we argue that some purely correlational (...)
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  8. How Do Medical Researchers Make Causal Inferences?Olaf Dammann, Ted Poston & Paul Thagard - 2020 - In Kevin McCain & Kostas Kampourakis (eds.), What is scientific knowledge? An introduction to contemporary epistemology of science. London, UK: Routledge.
    Bradford Hill (1965) highlighted nine aspects of the complex evidential situation a medical researcher faces when determining whether a causal relation exists between a disease and various conditions associated with it. These aspects are widely cited in the literature on epidemiological inference as justifying an inference to a causal claim, but the epistemological basis of the Hill aspects is not understood. We offer an explanatory coherentist interpretation, explicated by Thagard's ECHO model of explanatory coherence. The ECHO model captures the complexity (...)
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  9. 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.
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  10. COVID-19 and Control: An Essay From a Pragmatic Perspective on Science.Tuomas K. Pernu - 2020 - Multidisciplinary Perspectives on the COVID-19 Pandemic.
    The COVID-19 pandemic has demonstrated how different (even conflicting) interventions on nature can be scientifically justified: interventions can be deemed "effective" only in relation to specific target variables - in relation to variables the values of which we seek to control. Choosing the "right" target variables, in turn, depends on our values and pragmatic aims. This essay is based on a presentation given at the symposium "Multidisciplinary Perspectives on the COVID-19 Pandemic", organised at the Helsinki Collegium for Advanced Studies on (...)
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  11. Evidence Amalgamation, Plausibility, and Cancer Research.Marta Bertolaso & Fabio Sterpetti - 2019 - Synthese 196 (8):3279-3317.
    Cancer research is experiencing ‘paradigm instability’, since there are two rival theories of carcinogenesis which confront themselves, namely the somatic mutation theory and the tissue organization field theory. Despite this theoretical uncertainty, a huge quantity of data is available thanks to the improvement of genome sequencing techniques. Some authors think that the development of new statistical tools will be able to overcome the lack of a shared theoretical perspective on cancer by amalgamating as many data as possible. We think instead (...)
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  12. Moral Normative Force and Clinical Ethics Expertise.Parker Crutchfield - 2019 - American Journal of Bioethics 19 (11):89-91.
    Brummett and Salter propose a useful and timely taxonomy of clinical ethics expertise (2019). As the field becomes further “professionalized” this taxonomy is important, and the core of it is right. It needs some refinement around the edges, however. In their conclusion, Brummett and Salter rightly point out that there is a significant difference between the ethicist whose recommendations are procedure- and process-heavy, consensus-driven, and dialogical and the authoritarian ethicist whose recommendations flow from “private moral views” (Brummett and Salter, 2019). (...)
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  13. The Ideological Matrix of Science: Natural Selection and Immunity as Case Studies.Agustin Ostachuk - 2019 - Cosmos and History: The Journal of Natural and Social Philosophy 15 (1):182-213.
    The modern concept of ideology was established by the liberal politician and philosopher Destutt de Tracy, with the objective of creating an all-embracing and general science of ideas, which followed the sensualist and empiricist trend initiated by Locke that culminated in the positivism of Comte. Natural selection and immunity are two key concepts in the history of biology that were strongly based on the Malthusian concept of struggle for existence. This concept wrongly assumed that population grew faster than the means (...)
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  14. 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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  15. Ethical and Moral Concerns Regarding Artificial Intelligence in Law and Medicine.Soaad Hossain - 2018 - Journal of Undergraduate Life Sciences 12 (1):10.
    This paper summarizes the seminar AI in Medicine in Context: Hopes? Nightmares? that was held at the Centre for Ethics at the University of Toronto on October 17, 2017, with special guest assistant professor and neurosurgeon Dr. Sunit Das. The paper discusses the key points from Dr. Das' talk. Specifically, it discusses about Dr. Das' perspective on the ethical and moral issues that was experienced from applying artificial intelligence (AI) in law and how such issues can also arise when applying (...)
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  16. Cochrane Review as a “Warranting Device” for Reasoning About Health.Sally Jackson & Jodi Schneider - 2018 - Argumentation 32 (2):241-272.
    Contemporary reasoning about health is infused with the work products of experts, and expert reasoning about health itself is an active site for invention and design. Building on Toulmin’s largely undeveloped ideas on field-dependence, we argue that expert fields can develop new inference rules that, together with the backing they require, become accepted ways of drawing and defending conclusions. The new inference rules themselves function as warrants, and we introduce the term “warranting device” to refer to an assembly of the (...)
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  17. Medizin als Wissenschaft - eine wissenschaftstheoretische Analyse.Holger Lyre - 2018 - In Daniela Ringkamp & Héctor Wittwer (eds.), Was ist Medizin? Der Begriff der Medizin und seine ethischen Implikationen. Alber.
    Gegenstand dieses Beitrags ist eine Auseinandersetzung mit der Wissenschaftlichkeit der Medizin. Den Leitfaden der Analyse bildet dabei ein jüngerer Ansatz in der analytischen Wissenschaftstheorie, wonach Systematizität als zentrales Kriterium von Wissenschaft anzusehen ist (Hoyningen-Huene 2013). Ich werde im Detail zeigen, dass die Medizin dieses mehrdimensionale Kriterium insgesamt erfüllt, dass aus der Wissenschaftlichkeit der Medizin aber gleichwohl normative Konsequenzen folgen, die beispielsweise zur Abgrenzung von der Homöopathie und einer kritischen Bewertung des biopsychosozialen Modells führen. Zudem resultieren der Anwendungscharakter der Medizin und (...)
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  18. The Evolution Concept: The Concept Evolution.Agustin Ostachuk - 2018 - Cosmos and History: The Journal of Natural and Social Philosophy 14 (3):354-378.
    This is an epistemologically-driven history of the concept of evolution. Starting from its inception, this work will follow the development of this pregnant concept. However, in contradistinction to previous attempts, the objective will not be the identification of the different meanings it adopted through history, but conversely, it will let the concept to be unfolded, to be explicated and to express its own inner potentialities. The underlying thesis of the present work is, therefore, that the path that leads to the (...)
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  19. Renewing Medicine’s Basic Concepts: On Ambiguity.Joel Michael Reynolds - 2018 - Philosophy, Ethics, and Humanities in Medicine 13 (1):8.
    In this paper, I argue that the concept of normality in medical research and clinical practice is inextricable from the concept of ambiguity. I make this argument in the context of Edmund Pellegrino's call for a renewed reflection on medicine’s basic concepts and by drawing on work in critical disability studies concerning Deafness and body integrity identity disorder. If medical practitioners and philosophers of medicine wish to improve their understanding of the meaning of medicine as well as its concrete practice, (...)
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  20. 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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  21. Epistemic Injustice and Illness.Ian James Kidd & Havi Carel - 2017 - Journal of Applied Philosophy 34 (2):172-190.
    This article analyses the phenomenon of epistemic injustice within contemporary healthcare. We begin by detailing the persistent complaints patients make about their testimonial frustration and hermeneutical marginalization, and the negative impact this has on their care. We offer an epistemic analysis of this problem using Miranda Fricker's account of epistemic injustice. We detail two types of epistemic injustice, testimonial and hermeneutical, and identify the negative stereotypes and structural features of modern healthcare practices that generate them. We claim that these stereotypes (...)
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  22. ¿Es la medicalización un fenómeno negativo? Un análisis de las consecuencias que suelen atribuirse a la medicalización?Alberto Oya - 2017 - Daimon: Revista Internacional de Filosofía (71):7-18.
    En este artículo expondré un análisis de la valoración negativa de las consecuencias que suelen atribuirse al fenómeno de la medicalización y, partiendo de aquí, mi objetivo básico será mostrar que la medicalización no es en sí mismo un fenómeno negativo. Sólo lo será cuando se obtenga un valor negativo del cálculo entre, por un lado, la efectividad de la propuesta médica para solucionar el problema y, por otro lado, el balance entre los beneficios de dicha propuesta médica y sus (...)
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  23. 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, since the two seem committed (...)
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  24. Translating Trial Results in Clinical Practice: The Risk GP Model.Jonathan Fuller & Luis J. Flores - 2016 - Journal of Cardiovascular Translational Research 9:167-168.
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  25. Nerve/Nurses of the Cosmic Doctor: Wang Yang-Ming on Self-Awareness as World-Awareness.Joshua M. Hall - 2016 - Asian Philosophy 26 (2):149-165.
    In Philip J. Ivanhoe’s introduction to his Readings from the Lu-Wang School of Neo-Confucianism, he argues convincingly that the Ming-era Neo-Confucian philosopher Wang Yang-ming (1472–1529) was much more influenced by Buddhism (especially Zen’s Platform Sutra) than has generally been recognized. In light of this influence, and the centrality of questions of selfhood in Buddhism, in this article I will explore the theme of selfhood in Wang’s Neo-Confucianism. Put as a mantra, for Wang “self-awareness is world-awareness.” My central image for this (...)
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  26. Hollow Hunt for Harms.Jacob Stegenga - 2016 - Perspectives on Science 24 (5):481-504.
    Harms of medical interventions are systematically underestimated in clinical research. Numerous factors—conceptual, methodological, and social—contribute to this underestimation. I articulate the depth of such underestimation by describing these factors at the various stages of clinical research. Before any evidence is gathered, the ways harms are operationalized in clinical research contributes to their underestimation. Medical interventions are first tested in phase 1 ‘first in human’ trials, but evidence from these trials is rarely published, despite the fact that such trials provide the (...)
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  27. Objectivity, Scientificity, and the Dualist Epistemology of Medicine.Thomas V. Cunningham - 2015 - In P. Huneman (ed.), Classification, Disease, and Evidence. Springer Science + Business. pp. 01-17.
    This paper considers the view that medicine is both “science” and “art.” It is argued that on this view certain clinical knowledge – of patients’ histories, values, and preferences, and how to integrate them in decision-making – cannot be scientific knowledge. However, by drawing on recent work in philosophy of science it is argued that progress in gaining such knowledge has been achieved by the accumulation of what should be understood as “scientific” knowledge. I claim there are varying degrees of (...)
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  28. 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.
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  29. 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.
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  30. 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.
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  31. Life as Normative Activity and Self-realization: Debate surrounding the Concept of Biological Normativity in Goldstein and Canguilhem.Agustin Ostachuk - 2015 - História, Ciências, Saúde - Manguinhos 22 (4):1199-1214.
    The influence of Kurt Goldstein on the thinking of Georges Canguilhem extended throughout his entire work. This paper seeks to examine this relationship in order to conduct a study of the norm as a nexus or connection between the concept and life. Consequently, this work will be a reflection on the approach to life as a normative activity and self-realization. For this, it will be necessary to redefine the concepts of health and disease, and make a crossover between the two. (...)
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  32. Measuring Effectiveness.Jacob Stegenga - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54:62-71.
    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 (...)
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  33. Effectiveness of Medical Interventions.Jacob Stegenga - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54:34-44.
    To be effective, a medical intervention must improve one's health by targeting a disease. The concept of disease, though, is controversial. Among the leading accounts of disease-naturalism, normativism, hybridism, and eliminativism-I defend a version of hybridism. A hybrid account of disease holds that for a state to be a disease that state must both (i) have a constitutive causal basis and (ii) cause harm. The dual requirement of hybridism entails that a medical intervention, to be deemed effective, must target either (...)
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  34. The Continuing Relevance of 19th-Century Philosophy of Psychology: Brentano and the Autonomy of Psychological Methods.Uljana Feest - 2014 - In M. C. Galavotti & F. Stadler (eds.), New Directions in the Philosophy of Science, The Philosophy of Science in a European Perspective 5. Springer. Springer. pp. 693-709.
    This paper provides an analysis of Franz Brentano’s thesis that psychology employs a distinctive method, which sets it apart from physiology. The aim of the paper is two-fold: First, I situate Brentano’s thesis (and the broader metaphysical system that underwrites it) within the context of specific debates about the nature and status of psychology, arguing that we regard him as engaging in a form of boundary work. Second, I explore the relevance of Brentano’s considerations to more recent debates about autonomy (...)
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  35. Corroborating Evidence‐Based 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 that the emphasis on evidence (...)
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  36. Introducing Knowledge-Based Medicine - Conference Presentation - Medicine is Not Science: Guessing the Future, Predicting the Past.Clifford Miller - 2014 - Conference Presentation Universidad Franscisco de Vitoria Person Centered Medicine July 2014; 07/2014.
    There is a middle ground of imperfect knowledge in fields like medicine and the social sciences. It stands between our day-to-day relatively certain knowledge obtained from ordinary basic observation of regularities in our world and our knowledge from well-validated theories in the physical sciences. -/- The latter enable reliable prediction a great deal of the time of the happening of events never before experienced. The former enable prediction only of what has happened before and beyond that of educated guesses which (...)
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  37. Down with the Hierarchies.Jacob Stegenga - 2014 - Topoi 33 (2):313-322.
    Evidence hierarchies are widely used to assess evidence in systematic reviews of medical studies. I give several arguments against the use of evidence hierarchies. The problems with evidence hierarchies are numerous, and include methodological shortcomings, philosophical problems, and formal constraints. I argue that medical science should not employ evidence hierarchies, including even the latest and most-sophisticated of such hierarchies.
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  38. Book Review Jeremy Howick , The Philosophy of Evidence-Based Medicine . Chichester: Wiley-Blackwell (2011), 248 Pp., $61.95 (Paper).Alex Broadbent - 2013 - Philosophy of Science 80 (1):165-168.
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  39. Unifying Diseases From a Genetic Point of View: The Example of the Genetic Theory of Infectious Diseases.Marie Darrason - 2013 - Theoretical Medicine and Bioethics 34 (4):327-344.
    In the contemporary biomedical literature, every disease is considered genetic. This extension of the concept of genetic disease is usually interpreted either in a trivial or genocentrist sense, but it is never taken seriously as the expression of a genetic theory of disease. However, a group of French researchers defend the idea of a genetic theory of infectious diseases. By identifying four common genetic mechanisms (Mendelian predisposition to multiple infections, Mendelian predisposition to one infection, and major gene and polygenic predispositions), (...)
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  40. Mechanisms: What Are They Evidence for in Evidence-Based Medicine?Holly Andersen - 2012 - Journal of Evaluation in Clinical Practice 18 (5):992-999.
    Even though the evidence‐based medicine movement (EBM) labels mechanisms a low quality form of evidence, consideration of the mechanisms on which medicine relies, and the distinct roles that mechanisms might play in clinical practice, offers a number of insights into EBM itself. In this paper, I examine the connections between EBM and mechanisms from several angles. I diagnose what went wrong in two examples where mechanistic reasoning failed to generate accurate predictions for how a dysfunctional mechanism would respond to intervention. (...)
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  41. Causation in Medicine.Brendan Clarke - 2012 - In Wenceslao J. Gonzalez (ed.), Conceptual Revolutions: from Cognitive Science to Medicine. Netbiblo.
    In this paper, I offer one example of conceptual change. Specifically, I contend that the discovery that viruses could cause cancer represents an excellent example of branch jumping, one of Thagard’s nine forms of conceptual change. Prior to about 1960, cancer was generally regarded as a degenerative, chronic, non-infectious disease. Cancer causation was therefore usually held to be a gradual process of accumulating cellular damage, caused by relatively non-specific component causes, acting over long periods of time. Viral infections, on the (...)
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  42. Causality in Medicine with Particular Reference to the Viral Causation of Cancers.Brendan Clarke - 2011 - Dissertation, University College London
    In this thesis, I give a metascientific account of causality in medicine. I begin with two historical cases of causal discovery. These are the discovery of the causation of Burkitt’s lymphoma by the Epstein-Barr virus, and of the various viral causes suggested for cervical cancer. These historical cases then support a philosophical discussion of causality in medicine. This begins with an introduction to the Russo- Williamson thesis (RWT), and discussion of a range of counter-arguments against it. Despite these, I argue (...)
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  43. Is Meta-Analysis the Platinum Standard of Evidence?Jacob Stegenga - 2011 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 42 (4):497-507.
    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 (...)
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  44. Perspectives on Evidence-Based Healthcare for Women.Maya J. Goldenberg - 2010 - Journal of Women's Health 19 (7):1235-1238.
    We live in an age of evidence-based healthcare, where the concept of evidence has been avidly and often uncritically embraced as a symbol of legitimacy, truth, and justice. By letting the evidence dictate healthcare decision making from the bedside to the policy level, the normative claims that inform decision making appear to be negotiated fairly—without subjectivity, prejudice, or bias. Thus, the term ‘‘evidence-based’’ is typically read in the health sciences as the empirically adequate standard of reasonable practice and a means (...)
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  45. Iconoclast or Creed? Objectivism, Pragmatism, and the Hierarchy of Evidence.Maya J. Goldenberg - 2009 - Perspectives in Biology and Medicine 52 (2):168-187.
    Because “evidence” is at issue in evidence-based medicine (EBM), the critical responses to the movement have taken up themes from post-positivist philosophy of science to demonstrate the untenability of the objectivist account of evidence. While these post-positivist critiques seem largely correct, I propose that when they focus their analyses on what counts as evidence, the critics miss important and desirable pragmatic features of the evidence-based approach. This article redirects critical attention toward EBM’s rigid hierarchy of evidence as the culprit of (...)
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  46. Randomized Controlled Trials and the Flow of Information: Comment on Cartwright.Sherrilyn Roush - 2009 - Philosophical Studies 143 (1):137-145.
    The transferability problem—whether the results of an experiment will transfer to a treatment population—affects not only Randomized Controlled Trials but any type of study. The problem for any given type of study can also, potentially, be addressed to some degree through many different types of study. The transferability problem for a given RCT can be investigated further through another RCT, but the variables to use in the further experiment must be discovered. This suggests we could do better on the epistemological (...)
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  47. Disclosure and Rationality: Comparative Risk Information and Decision-Making About Prevention.Peter H. Schwartz - 2009 - Theoretical Medicine and Bioethics 30 (3):199-213.
    With the growing focus on prevention in medicine, studies of how to describe risk have become increasing important. Recently, some researchers have argued against giving patients “comparative risk information,” such as data about whether their baseline risk of developing a particular disease is above or below average. The concern is that giving patients this information will interfere with their consideration of more relevant data, such as the specific chance of getting the disease (the “personal risk”), the risk reduction the treatment (...)
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  48. 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 apparent obviousness of EBM can and should (...)
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  49. On Evidence, Medical & Legal - Letter & Authors' Reply.Clifford Miller - 2005 - Journal of American Physicians and Surgeons 10 (4):98-99..
    This exchange of correspondence with a critic provides helpful explanations of aspects of the paper "On Evidence, Medical and Legal" by the same authors.
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  50. On Evidence, Medical and Legal.Donald W. Miller & Clifford Miller - 2005 - Journal of American Physicians and Surgeons 10 (3):70-75.
    Medicine, like law, is a pragmatic, probabilistic activity. Both require that decisions be made on the basis of available evidence, within a limited time. In contrast to law, medicine, particularly evidence-based medicine as it is currently practiced, aspires to a scientific standard of proof, one that is more certain than the standards of proof courts apply in civil and criminal proceedings. But medicine, as Dr. William Osler put it, is an "art of probabilities," or at best, a "science of uncertainty." (...)
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