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Evaluating evidence of mechanisms in medicine

Dordrecht, Netherlands: Springer. Edited by Brendan Clarke, Phyllis Illari, Michael P. Kelly, Charles Norell, Federica Russo, Beth Shaw, Christian Wallmann, Michael Wilde & Jon Williamson (2018)

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  1. Science and values: a two-way direction.Emanuele Ratti & Federica Russo - 2024 - European Journal for Philosophy of Science 14 (1):1-23.
    In the science and values literature, scholars have shown how science is influenced and shaped by values, often in opposition to the ‘value free’ ideal of science. In this paper, we aim to contribute to the science and values literature by showing that the relation between science and values flows not only from values into scientific practice, but also from (allegedly neutral) science to values themselves. The extant literature in the ‘science and values’ field focuses by and large on reconstructing, (...)
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  • Evidential monism, evidential pluralism, or evidential contextualism? An introduction to evidential diversity in the social sciences.Yafeng Shan & Jon Williamson - 2022 - Synthese 200 (4):1-6.
    Social scientists often draw on a variety of evidence for their causal inferences. There is also a call to use a greater variety of evidence in social science research. This topical collection examines the philosophical foundations and implications of evidential diversity in the social sciences. It assesses the application of Evidential Pluralism in the context of the social sciences, especially its application to economics and political science. It also discusses the concept of causation in cognitive science and the implications of (...)
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  • Evidence of effectiveness.Jacob Stegenga - 2022 - Studies in History and Philosophy of Science Part A 91 (C):288-295.
    There are two competing views regarding the role of mechanistic knowledge in inferences about the effectiveness of interventions. One view holds that inferences about the effectiveness of interventions should be based only on data from population-level studies (often statistical evidence from randomised trials). The other view holds that such inferences must be based in part on mechanistic evidence. The competing views are local principles of inference, the plausibility of which can be assessed by a more general normative principle of inference. (...)
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  • Applying Evidential Pluralism to the Social Sciences.Yafeng Shan & Jon Williamson - 2021 - European Journal for Philosophy of Science 11 (4):1-27.
    Evidential Pluralism maintains that in order to establish a causal claim one normally needs to establish the existence of an appropriate conditional correlation and the existence of an appropriate mechanism complex, so when assessing a causal claim one ought to consider both association studies and mechanistic studies. Hitherto, Evidential Pluralism has been applied to medicine, leading to the EBM+ programme, which recommends that evidence-based medicine should systematically evaluate mechanistic studies alongside clinical studies. This paper argues that Evidential Pluralism can also (...)
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  • Rules versus Standards: What Are the Costs of Epistemic Norms in Drug Regulation?David Teira & Mattia Andreoletti - 2019 - Science, Technology, and Human Values 44 (6):1093-1115.
    Over the last decade, philosophers of science have extensively criticized the epistemic superiority of randomized controlled trials for testing safety and effectiveness of new drugs, defending instead various forms of evidential pluralism. We argue that scientific methods in regulatory decision-making cannot be assessed in epistemic terms only: there are costs involved. Drawing on the legal distinction between rules and standards, we show that drug regulation based on evidential pluralism has much higher costs than our current RCT-based system. We analyze these (...)
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  • Mechanisms in clinical practice: use and justification.Mark R. Tonelli & Jon Williamson - 2020 - Medicine, Health Care and Philosophy 23 (1):115-124.
    While the importance of mechanisms in determining causality in medicine is currently the subject of active debate, the role of mechanistic reasoning in clinical practice has received far less attention. In this paper we look at this question in the context of the treatment of a particular individual, and argue that evidence of mechanisms is indeed key to various aspects of clinical practice, including assessing population-level research reports, diagnostic as well as therapeutic decision making, and the assessment of treatment effects. (...)
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  • Calibration for epistemic causality.Jon Williamson - 2021 - Erkenntnis 86 (4):941-960.
    The epistemic theory of causality is analogous to epistemic theories of probability. Most proponents of epistemic probability would argue that one's degrees of belief should be calibrated to chances, insofar as one has evidence of chances. The question arises as to whether causal beliefs should satisfy an analogous calibration norm. In this paper, I formulate a particular version of a norm requiring calibration to chances and argue that this norm is the most fundamental evidential norm for epistemic probability. I then (...)
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  • Evaluating evidential pluralism in epidemiology: mechanistic evidence in exposome research.Stefano Canali - 2019 - History and Philosophy of the Life Sciences 41 (1):4.
    In current philosophical discussions on evidence in the medical sciences, epidemiology has been used to exemplify a specific version of evidential pluralism. According to this view, known as the Russo–Williamson Thesis, evidence of both difference-making and mechanisms is produced to make causal claims in the health sciences. In this paper, I present an analysis of data and evidence in epidemiological practice, with a special focus on research on the exposome, and I cast doubt on the extent to which evidential pluralism (...)
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  • Emergence and Evidence: A Close Look at Bunge’s Philosophy of Medicine.Rainer J. Klement & Prasanta S. Bandyopadhyay - 2019 - Philosophies 4 (3):50.
    In his book “Medical Philosophy: Conceptual issues in Medicine”, Mario Bunge provides a unique account of medical philosophy that is deeply rooted in a realist ontology he calls “systemism”. According to systemism, the world consists of systems and their parts, and systems possess emergent properties that their parts lack. Events within systems may form causes and effects that are constantly conjoined via particular mechanisms. Bunge supports the views of the evidence-based medicine movement that randomized controlled trials (RCTs) provide the best (...)
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  • Causal Pluralism in Medicine and its Implications for Clinical Practice.Mariusz Maziarz - forthcoming - Journal for General Philosophy of Science / Zeitschrift für Allgemeine Wissenschaftstheorie:1-22.
    The existing philosophical views on what is the meaning of causality adequate to medicine are vastly divided. We approach this question and offer two arguments in favor of pluralism regarding concepts of causality. First, we analyze the three main types of research designs (randomized-controlled trials, observational epidemiology and laboratory research). We argue, using examples, that they allow for making causal conclusions that are best understood differently in each case (in agreement with a version of manipulationist, probabilistic and mechanistic definitions, respectively). (...)
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  • Six Theses on Mechanisms and Mechanistic Science.Stuart Glennan, Phyllis Illari & Erik Weber - 2022 - Journal for General Philosophy of Science / Zeitschrift für Allgemeine Wissenschaftstheorie 53 (2):143-161.
    In this paper we identify six theses that constitute core results of philosophical investigation into the nature of mechanisms, and of the role that the search for and identification of mechanisms play in the sciences. These theses represent the fruits of the body of research that is now often called New Mechanism. We concisely present the main arguments for these theses. In the literature, these arguments are scattered and often implicit. Our analysis can guide future research in many ways: it (...)
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  • Follow *the* science? On the marginal role of the social sciences in the COVID-19 pandemic.Simon Lohse & Stefano Canali - 2021 - European Journal for Philosophy of Science 11 (4):1-28.
    In this paper, we use the case of the COVID-19 pandemic in Europe to address the question of what kind of knowledge we should incorporate into public health policy. We show that policy-making during the COVID-19 pandemic has been biomedicine-centric in that its evidential basis marginalised input from non-biomedical disciplines. We then argue that in particular the social sciences could contribute essential expertise and evidence to public health policy in times of biomedical emergencies and that we should thus strive for (...)
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  • Establishing Causal Claims in Medicine.Jon Williamson - 2019 - International Studies in the Philosophy of Science 32 (1):33-61.
    Russo and Williamson put forward the following thesis: in order to establish a causal claim in medicine, one normally needs to establish both that the putative cause and putative effect are appropriately correlated and that there is some underlying mechanism that can account for this correlation. I argue that, although the Russo-Williamson thesis conflicts with the tenets of present-day evidence-based medicine, it offers a better causal epistemology than that provided by present-day EBM because it better explains two key aspects of (...)
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  • Models in Systems Medicine.Jon Williamson - 2017 - Disputatio 9 (47):429-469.
    Systems medicine is a promising new paradigm for discovering associations, causal relationships and mechanisms in medicine. But it faces some tough challenges that arise from the use of big data: in particular, the problem of how to integrate evidence and the problem of how to structure the development of models. I argue that objective Bayesian models offer one way of tackling the evidence integration problem. I also offer a general methodology for structuring the development of models, within which the objective (...)
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  • Evidence-based Medicine and Mechanistic Evidence: The Case of the Failed Rollout of Efavirenz in Zimbabwe.Andrew Park, Daniel Steel & Elicia Maine - 2023 - Journal of Medicine and Philosophy 48 (4):348-358.
    Evidence-based medicine (EBM) has long deemphasized mechanistic reasoning and pathophysiological rationale in assessing the effectiveness of interventions. The EBM+ movement has challenged this stance, arguing that evidence of mechanisms and comparative studies should both be seen as necessary and complementary. Advocates of EBM+ provide a combination of theoretical arguments and examples of mechanistic reasoning in medical research. However, EBM+ proponents have not provided recent examples of how downplaying mechanistic reasoning resulted in worse medical results than would have occurred otherwise. Such (...)
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  • Treatment effectiveness, generalizability, and the explanatory/pragmatic-trial distinction.Steven Tresker - 2022 - Synthese 200 (4):1-29.
    The explanatory/pragmatic-trial distinction enjoys a burgeoning philosophical and medical literature and a significant contingent of support among philosophers and healthcare stakeholders as an important way to assess the design and results of randomized controlled trials. A major motivation has been the need to provide relevant, generalizable data to drive healthcare decisions. While talk of pragmatic and explanatory trials could be seen as convenient shorthand, the distinction can also be seen as harboring deeper issues related to inferential strategies used to evaluate (...)
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  • Treatment Effectiveness and the Russo–Williamson Thesis, EBM+, and Bradford Hill's Viewpoints.Steven Tresker - 2022 - International Studies in the Philosophy of Science 34 (3):131-158.
    Establishing the effectiveness of medical treatments is one of the most important aspects of medical practice. Bradford Hill's viewpoints play an important role in inferring causality in medicine,...
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  • Philosophy of medicine in 2021.Jeremy R. Simon & Maël Lemoine - 2021 - Theoretical Medicine and Bioethics 42 (5):187-191.
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  • Rethinking Evidence-Based Management.Erik Weber, Ann Wyverkens & Bert Leuridan - 2024 - Philosophy of Management 23 (1):59-84.
    Evidence-based management (EBMgt) is a relatively recent approach to management, developed by Denise Rousseau in a series of articles and in a book that she co-authored with Eric Barends (Barends & Rousseau 2018). It is based on the idea that good-quality management decisions require both critical thinking and use of the best available evidence. In this paper we want to contribute to the scholarship on evidence-based management by showing how its central concept – evidence – can and should be defined (...)
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  • Resolving empirical controversies with mechanistic evidence.Mariusz Maziarz - 2021 - Synthese 199 (3-4):9957-9978.
    The results of econometric modeling are fragile in the sense that minor changes in estimation techniques or sample can lead to statistical models that support inconsistent causal hypotheses. The fragility of econometric results undermines making conclusive inferences from the empirical literature. I argue that the program of evidential pluralism, which originated in the context of medicine and encapsulates to the normative reading of the Russo-Williamson Thesis that causal claims need the support of both difference-making and mechanistic evidence, offers a ground (...)
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  • Establishing the teratogenicity of Zika and evaluating causal criteria.Jon Williamson - 2018 - Synthese 198 (Suppl 10):2505-2518.
    The teratogenicity of the Zika virus was considered established in 2016, and is an interesting case because three different sets of causal criteria were used to assess teratogenicity. This paper appeals to the thesis of Russo and Williamson (2007) to devise an epistemological framework that can be used to compare and evaluate sets of causal criteria. The framework can also be used to decide when enough criteria are satisfied to establish causality. Arguably, the three sets of causal criteria considered here (...)
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  • Inferential Pluralism in Causal Reasoning from Randomized Experiments.Tudor M. Baetu - 2022 - Acta Biotheoretica 70 (4):1-20.
    Causal pluralism can be defended not only in respect to causal concepts and methodological guidelines, but also at the finer-grained level of causal inference from a particular source of evidence for causation. An argument for this last variety of pluralism is made based on an analysis of causal inference from randomized experiments (RCTs). Here, the causal interpretation of a statistically significant association can be established via multiple paths of reasoning, each relying on different assumptions and providing distinct elements of information (...)
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  • The failure of drug repurposing for COVID-19 as an effect of excessive hypothesis testing and weak mechanistic evidence.Mariusz Maziarz & Adrian Stencel - 2022 - History and Philosophy of the Life Sciences 44 (4):1-26.
    The current strategy of searching for an effective treatment for COVID-19 relies mainly on repurposing existing therapies developed to target other diseases. Conflicting results have emerged in regard to the efficacy of several tested compounds but later results were negative. The number of conducted and ongoing trials and the urgent need for a treatment pose the risk that false-positive results will be incorrectly interpreted as evidence for treatments’ efficacy and a ground for drug approval. Our purpose is twofold. First, we (...)
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  • Causality in medicine, and its relation to action, mechanisms, and probability: Donald Gillies: Causality, probability, and medicine. Abingdon: Routledge, 2018, 300pp, £29.99 E-Book.Daniel Auker-Howlett & Michael Edward Wilde - 2019 - Metascience 28 (3):387-391.
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  • The Epistemology of Non-distributive Profiles.Patrick Allo - 2020 - Philosophy and Technology 33 (3):379-409.
    The distinction between distributive and non-distributive profiles figures prominently in current evaluations of the ethical and epistemological risks that are associated with automated profiling practices. The diagnosis that non-distributive profiles may coincidentally situate an individual in the wrong category is often perceived as the central shortcoming of such profiles. According to this diagnosis, most risks can be retraced to the use of non-universal generalisations and various other statistical associations. This article develops a top-down analysis of non-distributive profiles in which this (...)
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  • Manipulative evidence and medical interventions: some qualifications.Raffaella Campaner & Matteo Cerri - 2020 - History and Philosophy of the Life Sciences 42 (2):1-15.
    The notion of causal evidence in medicine has been the subject of wide philosophical debate in recent years. The notion of evidence has been discussed mostly in connection with Evidence Based Medicine and, more in general, with the assessment of causal nexus in medical, and especially research contexts. “Manipulative evidence” is one of the notions of causal evidence that has stimulated much debate. It has been defined in slightly different ways, attributed different relevance, and recently placed at the core of (...)
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