Results for 'EBM'

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  1.  40
    An Epistemological Problem for Integration in EBM.Sasha Lawson-Frost - 2019 - Journal of Evaluation in Clinical Practice 25 (6):938-942.
    Evidence‐based medicine (EBM) calls for medical practitioners to “integrate” our best available evidence into clinical practice. A significant amount of the literature on EBM takes this integration to be unproblematic, focusing on questions like how to interpret evidence and engage with patient values, rather than critically looking at how these features of EBM can be implemented together. Other authors have also commented on this gap in the literature, for example, identifying the lack of clarity about how patient preferences and evidence (...)
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  2. 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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  3.  60
    Randomized Controlled Trials for Diagnostic Imaging: Conceptual and Pratical Problems.Elisabetta Lalumera & Stefano Fanti - 2019 - Topoi 38 (2):395-400.
    We raise a problem of applicability of RCTs to validate nuclear diagnostic imaging tests. In spite of the wide application of PET and other similar techniques that use radiopharmaceuticals for diagnostic purposes, RCT-based evidence on their validity is sparse. We claim that this is due to a general conceptual problem that we call Prevalence of Treatment, which arises in connection with designing RCTs for testing any diagnostic procedure in the present context of medical research, and is particularly apparent in this (...)
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  4. 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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  5. 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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  6. 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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  7. Rationality and the Generalization of Randomized Controlled Trial Evidence.Jonathan Fuller - 2013 - Journal of Evaluation in Clinical Practice 19 (4):644-647.
    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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  8. Values-Based Practice and Phenomenological Psychopathology: Implications of Existential Changes in Depression.Anthony Vincent Fernandez & Sarah Wieten - 2015 - Journal of Evaluation in Clinical Practice 21 (3):508-513.
    Values-based practice (VBP), developed as a partner theory to evidence-based medicine (EBM), takes into explicit consideration patients’ and clinicians’ values, preferences, concerns and expectations during the clinical encounter in order to make decisions about proper interventions. VBP takes seriously the importance of life narratives, as well as how such narratives fundamentally shape patients’ and clinicians’ values. It also helps to explain difficulties in the clinical encounter as conflicts of values. While we believe that VBP adds an important dimension to the (...)
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  9. 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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  10. Exposing the Vanities—and a Qualified Defense—of Mechanistic Reasoning in Health Care Decision Making.Jeremy Howick - 2011 - Philosophy of Science 78 (5):926-940.
    Philosophers of science have insisted that evidence of underlying mechanisms is required to support claims about the effects of medical interventions. Yet evidence about mechanisms does not feature on dominant evidence-based medicine “hierarchies.” After arguing that only inferences from mechanisms (“mechanistic reasoning”)—not mechanisms themselves—count as evidence, I argue for a middle ground. Mechanistic reasoning is not required to establish causation when we have high-quality controlled studies; moreover, mechanistic reasoning is more problematic than has been assumed. Yet where the problems can (...)
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  11. 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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  12. The Real World Failure of Evidence-Based Medicine.Donald W. Miller & Clifford Miller - 2011 - International Journal of Person Centered Medicine 1 (2):295-300.
    As a way to make medical decisions, Evidence-Based Medicine (EBM) has failed. EBM's failure arises from not being founded on real-world decision-making. EBM aspires to a scientific standard for the best way to treat a disease and determine its cause, but it fails to recognise that the scientific method is inapplicable to medical and other real-world decision-making. EBM also wrongly assumes that evidence can be marshaled and applied according to an hierarchy that is determined in an argument by authority to (...)
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  13. 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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  14. Information-Theoretic Classification of SNOMED Improves the Organization of Context-Sensitive Excerpts From Cochrane Reviews.Sam Lee, Borlawsky Tara, Tao Ying, Li Jianrong, Friedman Carol, Barry Smith & A. Lussier Yves - 2007 - In Proceedings of the Annual Symposium of the American Medical Informatics Association. Washington, DC: AMIA. pp. 645.
    The emphasis on evidence based medicine (EBM) has placed increased focus on finding timely answers to clinical questions in presence of patients. Using a combination of natural language processing for the generation of clinical excerpts and information theoretic distance based clustering, we evaluated multiple approaches for the efficient presentation of context-sensitive EBM excerpts.
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  15. Rationalism, Empiricism, and Evidence-Based Medicine: A Call for a New Galenic Synthesis.William Webb - 2018 - Medicines 5 (2).
    Thirty years after the rise of the evidence-based medicine (EBM) movement, formal training in philosophy remains poorly represented among medical students and their educators. In this paper, I argue that EBM’s reception in this context has resulted in a privileging of empiricism over rationalism in clinical reasoning with unintended consequences for medical practice. After a limited review of the history of medical epistemology, I argue that a solution to this problem can be found in the method of the 2nd-century Roman (...)
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  16. Philosophy of Evidence Based Medicine (Oxford Bibliography: Http://Www.Oxfordbibliographies.Com/View/Document/Obo-9780195396577/Obo-9780195396577-0253.Xml).Jeremy Howick, Ashley Graham Kennedy & Alexander Mebius - 2015 - Oxford Bibliography.
    Since its introduction just over two decades ago, evidence-based medicine (EBM) has come to dominate medical practice, teaching, and policy. There are a growing number of textbooks, journals, and websites dedicated to EBM research, teaching, and evidence dissemination. EBM was most recently defined as a method that integrates best research evidence with clinical expertise and patient values and circumstances in the treatment of patients. There have been debates throughout the early 21st century about what counts as good research evidence between (...)
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