Results for 'RCT'

18 found
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  1.  52
    An Unattractive Hypothesis – RCTs' Descent to Non-Science.Clifford Miller - 2011 - International Journal of Person Centered Medicine 1 (4):841-842.
    Eyal Shahar’s essay review [1] of James Penston’s remarkable book [2] seems more inspired playful academic provocation than review or essay, expressing dramatic views of impossible validity. The account given of modern biostatistical causation reveals the slide from science into the intellectual confusion and non-science RCTs have created: “…. the purpose of medical research is to estimate the magnitude of the effect of a causal contrast, for example the probability ratio of a binary outcome …” But Shahar’s world is simultaneously (...)
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  2. Is Meta-Analysis the Platinum Standard of Evidence?Jacob Stegenga - 2011 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 42 (4):497-507.
    An astonishing volume and diversity of evidence is available for many hypotheses in the biomedical and social sciences. Some of this evidence—usually from randomized controlled trials (RCTs)—is amalgamated by meta-analysis. Despite the ongoing debate regarding whether or not RCTs are the ‘gold-standard’ of evidence, it is usually meta-analysis which is considered the best source of evidence: meta-analysis is thought by many to be the platinum standard of evidence. However, I argue that meta-analysis falls far short of that standard. Different meta-analyses (...)
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  3. Herding QATs: Quality Assessment Tools for Evidence in Medicine.Jacob Stegenga - forthcoming - In Huneman, Silberstein & Lambert (eds.), Herding QATs: Quality Assessment Tools for Evidence in Medicine.
    Medical scientists employ ‘quality assessment tools’ (QATs) to measure the quality of evidence from clinical studies, especially randomized controlled trials (RCTs). These tools are designed to take into account various methodological details of clinical studies, including randomization, blinding, and other features of studies deemed relevant to minimizing bias and error. There are now dozens available. The various QATs on offer differ widely from each other, and second-order empirical studies show that QATs have low inter-rater reliability and low inter-tool reliability. This (...)
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  4.  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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  5. Randomized Controlled Trials and the Flow of Information: Comment on Cartwright.Sherrilyn Roush - 2009 - Philosophical Studies 143 (1):137-145.
    The transferability problem—whether the results of an experiment will transfer to a treatment population—affects not only Randomized Controlled Trials but any type of study. The problem for any given type of study can also, potentially, be addressed to some degree through many different types of study. The transferability problem for a given RCT can be investigated further through another RCT, but the variables to use in the further experiment must be discovered. This suggests we could do better on the epistemological (...)
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  6. Rhetoric and Argumentation: How Clinical Practice Guidelines Think.Jonathan Fuller - 2013 - Journal of Evaluation in Clinical Practice 19 (3):433-441.
    Introduction: Clinical practice guidelines (CPGs) are an important source of justification for clinical decisions in modern evidence-based practice. Yet, we have given little attention to how they argue their evidence. In particular, how do CPGs argue for treatment with long-term medications that are increasingly prescribed to older patients? Approach and rationale: I selected six disease-specific guidelines recommending treatment with five of the medication classes most commonly prescribed for seniors in Ontario, Canada. I considered the stated aims of these CPGs and (...)
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  7.  85
    Disagreement About Evidence-Based Policy.Nick Cowen & Nancy Cartwright - forthcoming - In Maria Baghramian, J. Adam Carter & Richard Rowland (eds.), Routledge Handbook of The Philosophy of Disagreement. Abingdon, United Kingdom: Routledge.
    Evidence based-policy (EBP) is a popular research paradigm in the applied social sciences and within government agencies. Informally, EBP represents an explicit commitment to applying scientific methods to public affairs, in contrast to ideologically-driven or merely intuitive “common-sense” approaches to public policy. More specifically, the EBP paradigm places great weight on the results of experimental research designs, especially randomised controlled trials (RCTs), and systematic literature reviews that place evidential weight on experimental results. One hope is that such research designs and (...)
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  8. Standard of Care, Institutional Obligations, and Distributive Justice.Douglas MacKay - 2015 - Bioethics 29 (4):352-359.
    The problem of standard of care in clinical research concerns the level of treatment that investigators must provide to subjects in clinical trials. Commentators often formulate answers to this problem by appealing to two distinct types of obligations: professional obligations and natural duties. In this article, I investigate whether investigators also possess institutional obligations that are directly relevant to the problem of standard of care, that is, those obligations a person has because she occupies a particular institutional role. I examine (...)
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  9.  48
    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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  10. 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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  11.  87
    An Argument for Fewer Clinical Trials.Kirstin Borgerson - 2016 - Hastings Center Report 46 (6):25-35.
    The volume of clinical research is increasing exponentially—far beyond our ability to process and absorb the results. Given this situation, it may be beneficial to consider reducing the flow at its source. In what follows, I will motivate and critically evaluate the following proposal: researchers should conduct fewer clinical trials. More specifically, I c onsider whether researchers should be permitted to conduct only clinical research of very high quality and, in turn, whether research ethics committees should prohibit all other, lower-quality (...)
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  12.  77
    Bayesian Versus Frequentist Clinical Trials.David Teira - 2011 - In Gifford Fred (ed.), Philosophy of Medicine. Amsterdam: Elsevier. pp. 255-297.
    I will open the first part of this paper by trying to elucidate the frequentist foundations of RCTs. I will then present a number of methodological objections against the viability of these inferential principles in the conduct of actual clinical trials. In the following section, I will explore the main ethical issues in frequentist trials, namely those related to randomisation and the use of stopping rules. In the final section of the first part, I will analyse why RCTs were accepted (...)
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  13. Can Economics Can Be a Separate Science?Lukas Beck - 2017 - Rerum Causae 9 (2):17-36.
    Mill (1872, 1874) is an early proponent of the thesis that economics has a special domain in which it can operate relatively independently of findings from other sciences. Contra Mill, I argue that this so-called separateness-thesis is best defendedunder an externalist interpretation of Rational Choice Theory (RCT). Mill’s defence is consistent with an internalist interpretation of RCT. Internalism holds that RCT depicts psychological mechanisms operating in economic agents. I argue that such a defence fails to establish separateness, because it makes (...)
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  14. Hypochondria and Self-Recalibration.Sherrilyn Roush - manuscript
    Health anxiety is, among other things, a response to a universal epistemological problem about whether changes in one’s body indicate serious illness, a problem that grows more challenging to the individual with age and with every advance in medical science, detection, and treatment. There is growing evidence that dysfunctional metacognitive beliefs – beliefs about thinking – are the driving factor, with dysfunctional substantive beliefs about the probability of illness a side‐effect, and that Metacognitive Therapy (MCT) is more effective than Cognitive (...)
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  15. 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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  16. Introducing Regime Cluster Theory: Framing Regional Diffusion Dynamics of Democratization and Autocracy Promotion.Jeroen Van den Bosch - 2020 - International Journal of Political Theory 4 (1):74-106.
    Recently the role of ideology and hegemony has received increased attention to explain varying dynamics of diffusion and autocratic cooperation. As a result, patterns of interaction in clusters from regions without hegemony or ideology have been overlooked because their autocracy-toautocracy transitions are no threat to the global status of democracy, even when active regime promotion is very common. This article will apply insights from economic cluster theory to political regimes and introduce a typology to differentiate among clusters. Regime Cluster Theory (...)
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  17. Van Gordon, W., Shonin, E., Dunn, T., Garcia-Campayo, J., & Griffiths, M. D. (2017). Meditation Awareness Training for the Treatment of Fibromyalgia: A Randomised Controlled Trial. British Journal of Health Psychology, 22, 186-206.William Van Gordon, Edo Shonin, Thomas Dunn, Javier Garcia-Campayo & Mark Griffiths - 2017 - British Journal of Health Psychology 22:186-206.
    Objectives. The purpose of this study was to conduct the first randomized controlled trial (RCT) to evaluate the effectiveness of a second-generation mindfulness-based intervention (SG-MBI) for treating fibromyalgia syndrome (FMS). Compared to first generation mindfulness-based interventions, SG-MBIs are more acknowledging of the spiritual aspect of mindfulness. Design. A RCT employing intent-to-treat analysis. Methods. Adults with FMS received an 8-week SG-MBI known as meditation awareness training (MAT; n = 74) or an active control intervention known as cognitive behaviour theory for groups (...)
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  18. Interpersonal Comparisons of Well-Being, the Evaluative Attitudes, and Type Correspondence Between Mind and Brain.JP Sevilla - manuscript
    Interpersonal comparisons of well-being (ICWs) confront the longstanding unsolved epistemic problem of other minds (EPOM): the problem of how to achieve objective knowledge of people's subjective mental states. The intractability of the EPOM may lead to the hope that Rational Choice Theory (RCT) can show that information about how people would choose over goods and gambles is sufficient--and information about subjective mental states therefore unnecessary--for interpersonal comparisons of levels and changes in well-being, thereby bypassing the EPOM. I argue that this (...)
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