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Switch to: References
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When appraising research papers, how much understanding is enough? More specifically, in deciding whether research results can inform practice, do appraisers need to substantively understand how findings are derived or is it sufficient simply to grasp that suitable analytic techniques were chosen and used by researchers? The degree or depth of understanding that research appraisers need to attain before findings can legitimately/sensibly inform practice is underexplored. In this paper it is argued that, where knowledge/justified beliefs derived from research evidence prompt (...) |
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Medical necessity (claiming that a medical intervention or care is – at minimum – reasonable, appropriate and acceptable) depends on empirical evidence and on the interpretation of that evidence. Evidence and its interpretation define the standard of care. This commentary argues that both the evidence base and its interpretation are currently weak gatekeepers. Empirical meta-research suggests that very few medical interventions have high quality evidence in support of their effectiveness and very few of them also have relatively thorough assessments of (...) |
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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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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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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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Policy-makers face an uncertain world. One way of getting a handle on decision-making in such an environment is to rely on evidence. Despite the recent increase in post-fact figures in politics, evidence-based policymaking takes centre stage in policy-setting institutions. Often, however, policy-makers face large volumes of evidence from different sources. Robustness analysis can, prima facie, handle this evidential diversity. Roughly, a hypothesis is supported by robust evidence if the different evidential sources are in agreement. In this thesis, I strengthen the (...) |
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