Archives For evidence based medicine

Author Information: Justin Parkhurst, London School of Hygiene and Tropical Medicine, Justin.Parkhurst@lshtm.ac.uk

Parkhurst, Justin. “Posing Questions, Eschewing Hierarchies: A Response to Katikireddi.” [1]. Social Epistemology Review and Reply Collective 4, no. 12 (2015): 62-67.

The PDF of the article gives specific page numbers. Shortlink: http://wp.me/p1Bfg0-2xd

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evidence_based_practice

Image credit: Fort Belvoir Community Hospital, via flickr

Vittal Katikireddi (2015) raises a number of points in response to our original article (Parkhurst and Abeysinghe 2014) to which I respond here. In one respect, there is general agreement with many of Katikireddi’s points. What may differ is the perspective we take in terms of the phenomenon we are observing—not that there has not been advancements in thinking on the use of evidence in the policy sciences community—which there no doubt has been—but that these insights often sit unrecognised in popular discourses within social policy and public policy circles who continue to look to use evidence in functional ways to improve effectiveness or efficiency of decisions.  Continue Reading…

Author Information: Srinivasa Vittal Katikireddi, University of Glasgow, vittal.katikireddi@glasgow.ac.uk

Katikireddi, Srinivasa Vittal. “Reply to ‘What Constitutes “Good” Evidence for Public Health and Social Policy Making? From Hierarchies to Appropriateness’.” Social Epistemology Review and Reply Collective 4, no. 8 (2015): 51-55.

The PDF of the article gives specific page numbers. Shortlink: http://wp.me/p1Bfg0-2eE

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public_health

Image credit: kafka4prez, via flickr

The academic community has long considered how knowledge can and should influence decision-making. The evidence-based medicine movement rose to prominence in the 1990s, with its influence extending from clinical decisions to areas of social policy. Parkhurst and Abeysinghe provide a useful addition to the literature which ambitiously draws on three different disciplinary perspectives—political science, philosophy of science and the sociology of knowledge—to reflect on the limitations of evidence hierarchies for informing policy decisions (2014). Public health is perhaps a natural focus of enquiry, drawing as it does on clinical disciplines as well as the social and political sciences.  Continue Reading…

Author Information: Justin O. Parkhurst, London School of Hygiene and Tropical Medicine, justin.parkhurst@lshtm.ac.uk ; Sudeepa Abeysinghe, University of Edinburgh, Sudeepa.Abeysinge@ed.ac.uk

Parkhurst, Justin O and Sudeepa Abeysinghe. “What Constitutes ‘Good’ Evidence for Public Health and Social Policy Making? From Hierarchies to Appropriateness.” Social Epistemology Review and Reply Collective 3, no 10 (2014): 40-52.

The PDF of the article gives specific page numbers. Shortlink: http://wp.me/p1Bfg0-1E3

Abstract

Within public health, and increasingly other areas of social policy, there are widespread calls to increase or improve the use of evidence for policy making. Often these calls rest on an assumption that increased evidence utilisation will be a more efficient or effective means of achieving social goals. Yet a clear elucidation of what can be considered ‘good evidence’ for policy is rarely articulated. Many of the current discussions of best practice in the health policy sector derive from the evidence-based medicine (EBM) movement, embracing the ‘hierarchy of evidence’ that places experimental trials as preeminent in terms of methodological quality. However, a number of problems arise if these hierarchies are used to rank or prioritise policy relevance. Continue Reading…

Author Information: Sharyn Clough, Oregon State University, sharyn.clough@oregonstate.edu

Clough, Sharyn. “Feminist Theories of Evidence and Biomedical Research Communities: A Reply to Goldenberg.” Social Epistemology Review and Reply Collective 2, no. 12 (2013): 72-76.

The PDF of the article gives specific page numbers. Shortlink: http://wp.me/p1Bfg0-1aN

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In a recent essay — “How Can Feminist Theories of Evidence Assist Clinical Reasoning and Decision-making?” — Maya Goldenberg discusses criticisms of evidence-based medicine (or EBM) (Goldenberg 2013). She is particularly interested in those criticisms that make use of an epistemic appeal to the underdetermination of theory by evidence. That the choice of medical treatment regimens, for example, is often, if not always, underdetermined by the experimental evidence, suggests that something in addition to the evidence must be at play when treatments are championed by EBM protocols. Values, or other biases, are often mentioned as additional factors. In these cases, we have reason to be suspicious of claims to value-neutrality and objectivity that are often used to promote evidence-based medicine. Interestingly, she notes, it is feminist philosophers who most often critically deploy underdetermination theory, though they also typically offer a solution: all is not lost, some kind of objectivity can still be salvaged in research contexts. The solution typically involves reconfiguring notions of objectivity as a property of democratic and diverse research communities.  Continue Reading…