BACKGROUND AND RATIONALE: Evidence based medicine is the present backbone of rational and objective, modern medical problem solving and is a meeting ground for quantitative and qualitative researchers alike as it culminates into applying the fruits of clinical research to the individual patient. A systematic enquiry into the evolving paradigms in EBM is a need of the hour. AIMS AND METHODS: A qualitative enquiry examining the impact of different methodologies in EBM and their role in generating meaning interpretable at individual (...) levels. RESULTS: Present day outcome based research deals less with patients as individuals than as populations. Evidence based medicine struggles to apply the fruits of population based research to individuals who are often not as predictable as linear quantitative research would like them to be. The present EBM literature neglects a lot of events it doesn't believe to be statistically significant and perhaps here is an area that needs to be improved on - it assumes that because associations are demonstrated between interventions and outcomes in RCTs/meta-analysis, these associations are linear and causal in the real world. While they may be demonstrated repeatedly in highly controlled environments, in the real 'uncontrolled' world of clinical practice with real people, their validity breaks down. CONCLUSIONS: One needs to make the EBM standard model patient-individual (a projection of collective patient event data) resemble the real human individual patient so that optimal EBM individual data that matches our query can be easily and quickly spotted from the dense jungle of information that has grown over the years. This hints at rethinking our entire research methodology and modifying it to suit the needs of the individual patient. (shrink)

This book reformulates the sociological subdiscipline known as the sociology of knowledge. Knowledge is presented as more than ideology, including as well false consciousness, propaganda, science and art.

How physicians approach patients and the problems they present is much influenced by the conceptual models around which their knowledge is organized. In this paper the implications of the biopsychosocial model for the study and care of a patient with an acute myocardial infarction are presented and contrasted with approaches used by adherents of the more traditional biomedical model. CiteULike Connotea Del.icio.us What's this?

The notion that our society, its education system and its intellectual life, is characterised by a split between two cultures – the arts or humanities on one hand, and the sciences on the other – has a long history. But it was C. P. Snow's Rede lecture of 1959 that brought it to prominence and began a public debate that is still raging in the media today. This 50th anniversary printing of The Two Cultures and its successor piece, A Second (...) Look features an introduction by Stefan Collini, charting the history and context of the debate, its implications and its afterlife. The importance of science and technology in policy run largely by non-scientists, the future for education and research, and the problem of fragmentation threatening hopes for a common culture are just some of the subjects discussed. (shrink)

Examines the philosophical and clinical history of scientific medicine, and critiques the movements in psychoneuroimmunology and holistic and environmental medicine.