The Philosophy of Evidence-based Medicine
1. Auflage April 2011
244 Seiten, Softcover
Wiley & Sons Ltd
ISBN:
978-1-4051-9667-3
John Wiley & Sons
Evidence-based medicine (EBM) has become a required element of clinical practice, but it is critical for the healthcare community to understand the ongoing controversy surrounding EBM. Seeking to address questions raised by critics, The Philosophy of Evidence-based Medicine challenges the over dependency of EBM on randomized controlled trials. This book also explores EBM methodology and its relationship with other approaches used in medicine.
Chapter 1. The Philosophy of Evidence-Based Medicine
Chapter 2. What is EBM?
Chapter 3. What is good evidence for a clinical decision?
Chapter 4. Ruling out plausible rival hypotheses and confounding factors: A method
Chapter 5. Resolving the Paradox of Effectiveness: When do Observational Studies offer the Same Degree of Evidential Support as Randomized Trials?
Chapter 6. Questioning Double-Blinding as a Universal Methodological Virtue of Clinical Trials: resolving the Philip's Paradox
Chapter 7. Placebo controls: problematic and misleading baseline measures of effectiveness
Chapter 8. Questioning the methodological superiority of 'placebo' over 'active' controlled trials
Chapter 9. Transition to Part III. Examining the paradox that traditional roles for mechanistic reasoning and expert judgment have been up-ended by EBM
Chapter 10. A Qualified Defence of the EBM stance on Mechanistic Reasoning
Chapter 11. Knowledge that versus knowledge how: situating the EBM position on Expert Clinical Judgment
Chapter 12. Moving EBM forward
Chapter 2. What is EBM?
Chapter 3. What is good evidence for a clinical decision?
Chapter 4. Ruling out plausible rival hypotheses and confounding factors: A method
Chapter 5. Resolving the Paradox of Effectiveness: When do Observational Studies offer the Same Degree of Evidential Support as Randomized Trials?
Chapter 6. Questioning Double-Blinding as a Universal Methodological Virtue of Clinical Trials: resolving the Philip's Paradox
Chapter 7. Placebo controls: problematic and misleading baseline measures of effectiveness
Chapter 8. Questioning the methodological superiority of 'placebo' over 'active' controlled trials
Chapter 9. Transition to Part III. Examining the paradox that traditional roles for mechanistic reasoning and expert judgment have been up-ended by EBM
Chapter 10. A Qualified Defence of the EBM stance on Mechanistic Reasoning
Chapter 11. Knowledge that versus knowledge how: situating the EBM position on Expert Clinical Judgment
Chapter 12. Moving EBM forward
"Well-written, concise, engaging. The Evidence-basedmedicine (from now on 'EBM') movement continues to go from strengthto strength, with their hierarchy of medical evidence widely agreedupon and very influential in the theoretical and practical."(The Guardian, 24 January 2014)
Review appeared in TheGuardian - 24 January 2014
"In conclusion, The Philosophy of Evidence-Based Medicine isa must-have as a source of knowledge of and reference to the EBMmovement. Howick presents the argument for EBM persuasively whilstgiving sufficient coverage to alternative positions. Ithoroughly recommend this text as both a 'way in' to the subjectand a source of deeper understanding in the latest stage ofmedicine's fascinating journey, full of twists and turns inthe search for the truth." (Economics &Philosophy, 1 January 2014)
"The book is well structured and makes an accessible andpleasant read. It deserves to be digested not only by philosopherswith a methodological bent but by practitioners of EBM. After twodecades of criticisms of various aspects of the increasinglypopular EBM way of reasoning, it is about time EBM defenders triedto strike back, clarifying and justifying their positions.Howick's book is a valuable effort that will hopefully enrichthe continuing debate." (Theoria, 1 April2013)"Jeremy Howick has written the most comprehensive and fairphilosophical treatment of EBM to date. Howick understands that EBMis not, first and foremost, a philosophical position, and that itsvarious components (e.g., evidence hierarchies) are not primarilyphilosophical theses. Rather, they are attempts to improve theefficacy of medicine.... The book approaches its topic with thetools of mainstream analytical philosophy of science." (Philosophyof Science, 2013)
"The Philosophy of Evidence Based Medicine helps answerthe question of how to think about medicine so thatjudgement can be made. The book addresses key questions aboutmedical decision-making, such as: what role should mechanisticreasoning have in determining appropriate medicalcare? And, what weight, if any, should be givento expert opinions? This isn't a book abouthow doctors think. It is about how doctors ought tothink.... The Philosophy of Evidence BasedMedicine is an extremely important andpractical book about evidence-based medicine, and I considerit to be one of the most important contemporary books on thesubject. I recommend it very highly." (The Medical Media Review,2012)
"In The Philosophy of Evidence-Based Medicine, JeremyHowick, PhD offers by far the most fully formed defence to date ofthe epistemology of EBM.... Well-written and as approachable as anywork in the philosophy of science might hope to be.... Howick is tobe commended for his careful analysis of epistemic ramifications ofmany of the methodologies of clinical epidemiology." (Journal ofEvaluation in Clinical Practice, 2011)
"Howick's book provides a good overview of EBM's defense of thehierarchy of evidence and an excellent reference list for readerswho want to know more about EBM and its critics." (Theory ofMedical Bioethics, 2011)
"Since the 1990s, the practice of medicine has become dominated bya new methodological reasoning process - that of evidence-basedmedicine. This book unpacks the assumptions inherent in thismethodology, shedding light on its contributions and limitations topatient care. It addresses misconceptions about and criticisms ofEBM in a cogent manner and provides valuable insight into how thecurrent world of medicine is being shaped. (Doody's, 2011)
Review appeared in TheGuardian - 24 January 2014
"In conclusion, The Philosophy of Evidence-Based Medicine isa must-have as a source of knowledge of and reference to the EBMmovement. Howick presents the argument for EBM persuasively whilstgiving sufficient coverage to alternative positions. Ithoroughly recommend this text as both a 'way in' to the subjectand a source of deeper understanding in the latest stage ofmedicine's fascinating journey, full of twists and turns inthe search for the truth." (Economics &Philosophy, 1 January 2014)
"The book is well structured and makes an accessible andpleasant read. It deserves to be digested not only by philosopherswith a methodological bent but by practitioners of EBM. After twodecades of criticisms of various aspects of the increasinglypopular EBM way of reasoning, it is about time EBM defenders triedto strike back, clarifying and justifying their positions.Howick's book is a valuable effort that will hopefully enrichthe continuing debate." (Theoria, 1 April2013)"Jeremy Howick has written the most comprehensive and fairphilosophical treatment of EBM to date. Howick understands that EBMis not, first and foremost, a philosophical position, and that itsvarious components (e.g., evidence hierarchies) are not primarilyphilosophical theses. Rather, they are attempts to improve theefficacy of medicine.... The book approaches its topic with thetools of mainstream analytical philosophy of science." (Philosophyof Science, 2013)
"The Philosophy of Evidence Based Medicine helps answerthe question of how to think about medicine so thatjudgement can be made. The book addresses key questions aboutmedical decision-making, such as: what role should mechanisticreasoning have in determining appropriate medicalcare? And, what weight, if any, should be givento expert opinions? This isn't a book abouthow doctors think. It is about how doctors ought tothink.... The Philosophy of Evidence BasedMedicine is an extremely important andpractical book about evidence-based medicine, and I considerit to be one of the most important contemporary books on thesubject. I recommend it very highly." (The Medical Media Review,2012)
"In The Philosophy of Evidence-Based Medicine, JeremyHowick, PhD offers by far the most fully formed defence to date ofthe epistemology of EBM.... Well-written and as approachable as anywork in the philosophy of science might hope to be.... Howick is tobe commended for his careful analysis of epistemic ramifications ofmany of the methodologies of clinical epidemiology." (Journal ofEvaluation in Clinical Practice, 2011)
"Howick's book provides a good overview of EBM's defense of thehierarchy of evidence and an excellent reference list for readerswho want to know more about EBM and its critics." (Theory ofMedical Bioethics, 2011)
"Since the 1990s, the practice of medicine has become dominated bya new methodological reasoning process - that of evidence-basedmedicine. This book unpacks the assumptions inherent in thismethodology, shedding light on its contributions and limitations topatient care. It addresses misconceptions about and criticisms ofEBM in a cogent manner and provides valuable insight into how thecurrent world of medicine is being shaped. (Doody's, 2011)
Jeremy Howick PhD
Centre for Evidence-Based Medicine, Department of Primary Care,
University of Oxford, UK
Centre for Evidence-Based Medicine, Department of Primary Care,
University of Oxford, UK