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  1. Mechanisms and the Evidence Hierarchy.Brendan Clarke, Donald Gillies, Phyllis Illari, Federica Russo & Jon Williamson - 2014 - Topoi 33 (2):339-360.
    Evidence-based medicine (EBM) makes use of explicit procedures for grading evidence for causal claims. Normally, these procedures categorise evidence of correlation produced by statistical trials as better evidence for a causal claim than evidence of mechanisms produced by other methods. We argue, in contrast, that evidence of mechanisms needs to be viewed as complementary to, rather than inferior to, evidence of correlation. In this paper we first set out the case for treating evidence of mechanisms alongside evidence of correlation in (...)
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  • 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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  • Indigenous ayahuasca ceremonies in the European context: structures, purposes, concepts.Mika Turkia - manuscript
    Psychedelics are currently being studied intensively for the treatment of various psychiatric disorders. Ayahuasca, a plant-based extract originating from the Amazonian area, is traditionally consumed in ritualistic group events. The related indigenous traditions date back hundreds of years and have amassed vast amounts of knowledge on the therapeutic use of psychedelic and non-psychedelic plant-based substances. -/- These traditions require a prospective ceremony facilitator to undergo years of intensive training to acquire knowledge, mental power or self-confidence, stability, sensitivity, intuitive treatment outcome (...)
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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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  • Self-treatment of psychosis and complex post-traumatic stress disorder with LSD and DMT—A retrospective case study.Mika Turkia - 2022 - Psychiatry Research Case Reports 1 (2):100029.
    This article describes a case of a teenager with early complex trauma due to chronic domestic violence. Cannabis use triggered auditory hallucinations, after which the teenager was diagnosed with an acute schizophrenia-like psychotic disorder. Antipsychotic medication did not fully resolve symptoms. Eventually the teenager chose to self-medicate with LSD in order to resolve a suicidal condition. The teenager carried out six unsupervised LSD sessions, followed by an extended period of almost daily use of inhaled low-dose DMT. Psychotic symptoms were mostly (...)
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  • Epistemological and Ethical Aspects of Time in Scientific Research.Daria Jadreškić - 2020 - Dissertation, Leibniz University Hannover
    This dissertation explores the influence of time constraints on different research practices. The first two parts present case studies, which serve as a basis for discussing the epistemological and ethical implications of temporal limitations in scientific research. Part I is a case study on gravitational wave research, conducted by the LIGO Scientific Collaboration. This exemplifies fundamental research – without immediate societal applications, open-ended in terms of timeline and in terms of research goals. It is based, in part, on qualitative interviews (...)
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  • Objectivity in Science: New Perspectives From Science and Technology Studies.Flavia Padovani, Alan Richardson & Jonathan Y. Tsou (eds.) - 2015 - Cham: Boston Studies in the Philosophy and History of Science, vol. 310. Springer.
    This highly multidisciplinary collection discusses an increasingly important topic among scholars in science and technology studies: objectivity in science. It features eleven essays on scientific objectivity from a variety of perspectives, including philosophy of science, history of science, and feminist philosophy. Topics addressed in the book include the nature and value of scientific objectivity, the history of objectivity, and objectivity in scientific journals and communities. Taken individually, the essays supply new methodological tools for theorizing what is valuable in the pursuit (...)
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  • Broadening the scope of our understanding of mechanisms: lessons from the history of the morning-after pill.Christopher ChoGlueck - 2021 - Synthese 198 (3):2223-2252.
    Philosophers of science and medicine now aspire to provide useful, socially relevant accounts of mechanism. Existing accounts have forged the path by attending to mechanisms in historical context, scientific practice, the special sciences, and policy. Yet, their primary focus has been on more proximate issues related to therapeutic effectiveness. To take the next step toward social relevance, we must investigate the challenges facing researchers, clinicians, and policy makers involving values and social context. Accordingly, we learn valuable lessons about the connections (...)
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  • Expanding the notion of mechanism to further understanding of biopsychosocial disorders? Depression and medically-unexplained pain as cases in point.Jan Pieter Konsman - 2024 - Studies in History and Philosophy of Science Part A 103 (C):123-136.
    Evidence-Based Medicine has little consideration for mechanisms and philosophers of science and medicine have recently made pleas to increase the place of mechanisms in the medical evidence hierarchy. However, in this debate the notions of mechanisms seem to be limited to 'mechanistic processes' and 'complex-systems mechanisms,' understood as 'componential causal systems'. I believe that this will not do full justice to how mechanisms are used in biological, psychological and social sciences and, consequently, in a more biopsychosocial approach to medicine. Here, (...)
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  • Drug Labels and Reproductive Health: How Values and Gender Norms Shape Regulatory Science at the FDA.Christopher ChoGlueck - 2019 - Dissertation, Indiana University
    The US Food and Drug Administration (FDA) is fraught with controversies over the role of values and politics in regulatory science, especially with drugs in the realm of reproductive health. Philosophers and science studies scholars have investigated the ways in which social context shapes medical knowledge through value judgments, and feminist scholars and activists have criticized sexism and injustice in reproductive medicine. Nonetheless, there has been no systematic study of values and gender norms in FDA drug regulation. I focus on (...)
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  • An Evidence-Hierarchical Decision Aid for Ranking in Evidence-Based Medici.Jürgen Landes - 2020 - In Barbara Osimani & Adam La Caze (eds.), Uncertainty in Pharmacology. pp. 231-259.
    This chapter addresses the problem of ranking available drugs in guideline development to support clinicians in their work. Based on a pragmatic approach to the notion of evidence and a hierarchical view on different kinds of evidence this chapter introduces a decision aid, HiDAD, which draws on the multi criteria decision making literature. This decision aid implements the wide-spread intuition that there are different kinds of evidence with varying degrees of importance by relying on a strict ordinal ordering of kinds (...)
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  • Reproducibility and the Concept of Numerical Solution.Johannes Lenhard & Uwe Küster - 2019 - Minds and Machines 29 (1):19-36.
    In this paper, we show that reproducibility is a severe problem that concerns simulation models. The reproducibility problem challenges the concept of numerical solution and hence the conception of what a simulation actually does. We provide an expanded picture of simulation that makes visible those steps of simulation modeling that are numerically relevant, but often escape notice in accounts of simulation. Examining these steps and analyzing a number of pertinent examples, we argue that numerical solutions are importantly different from usual (...)
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  • Casuistic Reasoning, Standards of Evidence, and Expertise on Elite Athletes’ Nutrition.Saana Jukola - 2019 - Philosophies 4 (2):19.
    This paper assesses the epistemic challenges of giving nutrition advice to elite athletes in light of recent philosophical discussion concerning evidence-based practice. Our trust in experts largely depends on the assumption that their advice is based on reliable evidence. In many fields, the evaluation of the reliability of evidence is made on the basis of standards that originate from evidence-based medicine. I show that at the Olympic or professional level, implementing nutritional plans in real-world competitions requires contextualization of knowledge in (...)
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  • What is nature capable of? Evidence, ontology and speculative medical humanities.Martin Savransky & Marsha Rosengarten - 2016 - Medical Humanities 42 (3):166-172.
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  • Problems with using mechanisms to solve the problem of extrapolation.Jeremy Howick, Paul Glasziou & Jeffrey K. Aronson - 2013 - Theoretical Medicine and Bioethics 34 (4):275-291.
    Proponents of evidence-based medicine and some philosophers of science seem to agree that knowledge of mechanisms can help solve the problem of applying results of controlled studies to target populations (‘the problem of extrapolation’). We describe the problem of extrapolation, characterize mechanisms, and outline how mechanistic knowledge might be used to solve the problem. Our main thesis is that there are four often overlooked problems with using mechanistic knowledge to solve the problem of extrapolation. First, our understanding of mechanisms is (...)
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  • Standards of evidence and causality in regulatory science: Risk and benefit assessment.José Luis Luján & Oliver Todt - 2020 - Studies in History and Philosophy of Science Part A 80 (C):82-89.
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  • Jeremy Howick The Philosophy of Evidence‐Based Medicine.Wiley‐Blackwell & BMJ Books, 2011. xiv + 229 pp. ISBN 978‐1‐4051‐9667‐3 (paperback). [REVIEW]Jesper Jerkert - 2013 - Theoria 79 (2):180-186.
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