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Author : Jeremy H. Howick Publisher : John Wiley & Sons Page : 248 pages File Size : 42,8 Mb Release : 2011-02-23 Category : Medical ISBN : 9781444342666
The Philosophy of Evidence-based Medicine by Jeremy H. Howick Pdf
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.
Author : Jeremy H. Howick Publisher : John Wiley & Sons Page : 0 pages File Size : 49,6 Mb Release : 2011-04-25 Category : Medical ISBN : 9781405196673
The Philosophy of Evidence-based Medicine by Jeremy H. Howick Pdf
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.
Evidence-Based Endocrinology by Victor M. Montori Pdf
Internationally recognized experts, pioneers, and opinion makers in evidence-based medicine (EBM) provocatively recast endocrine policy and practice in the light of EBM philosophy and principles. The authors explain the past, present, and future of EBM; consider its practical implications for endocrinology; demonstrate what the "evidence base" is in EBM; and present illustrative case studies by practicing evidence-based clinicians. Highlights include essays on why cost-effective analyses are problematic, the contrast between clinical investigations and large randomized trials, the role of Cochrane reviews and meta-analyses, and the curriculum requirements for training evidence-based endocrinologists.
Evaluating Evidence of Mechanisms in Medicine by Veli-Pekka Parkkinen,Christian Wallmann,Michael Wilde,Brendan Clarke,Phyllis Illari,Michael P Kelly,Charles Norell,Federica Russo,Beth Shaw,Jon Williamson Pdf
This book is open access under a CC BY license. This book is the first to develop explicit methods for evaluating evidence of mechanisms in the field of medicine. It explains why it can be important to make this evidence explicit, and describes how to take such evidence into account in the evidence appraisal process. In addition, it develops procedures for seeking evidence of mechanisms, for evaluating evidence of mechanisms, and for combining this evaluation with evidence of association in order to yield an overall assessment of effectiveness. Evidence-based medicine seeks to achieve improved health outcomes by making evidence explicit and by developing explicit methods for evaluating it. To date, evidence-based medicine has largely focused on evidence of association produced by clinical studies. As such, it has tended to overlook evidence of pathophysiological mechanisms and evidence of the mechanisms of action of interventions. The book offers a useful guide for all those whose work involves evaluating evidence in the health sciences, including those who need to determine the effectiveness of health interventions and those who need to ascertain the effects of environmental exposures.
This volume covers a wide range of conceptual, epistemological and methodological issues in the philosophy of science raised by reflection upon medical science and practice. Several chapters examine such general meta-scientific concepts as discovery, reduction, theories and models, causal inference and scientific realism as they apply to medicine or medical science in particular. Some discuss important concepts specific to medicine (diagnosis, health, disease, brain death). A topic such as evidence, for instance, is examined at a variety of levels, from social mechanisms for guiding evidence-based reasoning such as evidence-based medicine, consensus conferences, and clinical trials, to the more abstract analysis of experimentation, inference and uncertainty. Some chapters reflect on particular domains of medicine, including psychiatry, public health, and nursing. The contributions span a broad range of detailed cases from the science and practice of medicine, as well as a broad range of intellectual approaches, from conceptual analysis to detailed examinations of particular scientific papers or historical episodes. Chapters view philosophy of medicine from quite different angles Considers substantive cases from both medical science and practice Chapters from a distinguished array of contributors
Personalized Hip and Knee Joint Replacement by Charles Rivière,Pascal-André Vendittoli Pdf
This open access book describes and illustrates the surgical techniques, implants, and technologies used for the purpose of personalized implantation of hip and knee components. This new and flourishing treatment philosophy offers important benefits over conventional systematic techniques, including component positioning appropriate to individual anatomy, improved surgical reproducibility and prosthetic performance, and a reduction in complications. The techniques described in the book aim to reproduce patients’ native anatomy and physiological joint laxity, thereby improving the prosthetic hip/knee kinematics and functional outcomes in the quest of the forgotten joint. They include kinematically aligned total knee/total hip arthroplasty, partial knee replacement, and hip resurfacing. The relevance of available and emerging technological tools for these personalized approaches is also explained, with coverage of, for example, robotics, computer-assisted surgery, and augmented reality. Contributions from surgeons who are considered world leaders in diverse fields of this novel surgical philosophy make this open access book will invaluable to a wide readership, from trainees at all levels to consultants practicing lower limb surgery
Philosophy of Medicine by R. Paul Thompson,Ross E.G. Upshur Pdf
What kind of knowledge is medical knowledge? Can medicine be explained scientifically? Is disease a scientific concept, or do explanations of disease depend on values? What is "evidence-based" medicine? Are advances in neuroscience bringing us closer to a scientific understanding of the mind? The nature of medicine raises fundamental questions about explanation, causation, knowledge and ontology – questions that are central to philosophy as well as medicine. This book introduces the fundamental issues in philosophy of medicine for those coming to the subject for the first time, including: • understanding the physician–patient relationship: the phenomenology of the medical encounter. • Models and theories in biology and medicine: what role do theories play in medicine? Are they similar to scientific theories? • Randomised controlled trials: can scientific experiments be replicated in clinical medicine? What are the philosophical criticisms levelled at RCTs? • The concept of evidence in medical research: what do we mean by "evidence-based medicine"? Should all medicine be based on evidence? • Causation in medicine. • What do advances in neuroscience reveal about the relationship between mind and body? • Defining health and disease: are explanations of disease objective or do they depend on values? • Evolutionary medicine: what is the role of evolutionary biology in understanding medicine? Is it relevant? Extensive use of empirical examples and case studies are included throughout, including debates about smoking and cancer, the use of placebos in randomised controlled trials, controversies about PSA testing and research into the causes of HIV. This is an indispensable introduction to those teaching philosophy of medicine and philosophy of science.
Is Evidence-based Psychiatry Ethical? by Mona Gupta Pdf
In this groundbreaking book, psychiatrist and ethicist Mona Gupta analyzes the basic assumptions of Evidence-based medicine (EBM), and critically examines their applicability to psychiatry. Highlighting ethical tensions between psychiatry and EBM, she asks the controversial question - should psychiatrists practice evidence-based medicine at all?
How is medical knowledge made? New methods for research and clinical care have reshaped the practices of medical knowledge production over the last forty years. Consensus conferences, evidence-based medicine, translational medicine, and narrative medicine are among the most prominent new methods. Making Medical Knowledge explores their origins and aims, their epistemic strengths, and their epistemic weaknesses. Miriam Solomon argues that the familiar dichotomy between the art and the science of medicine is not adequate for understanding this plurality of methods. The book begins by tracing the development of medical consensus conferences, from their beginning at the United States' National Institutes of Health in 1977, to their widespread adoption in national and international contexts. It discusses consensus conferences as social epistemic institutions designed to embody democracy and achieve objectivity. Evidence-based medicine, which developed next, ranks expert consensus at the bottom of the evidence hierarchy, thus challenging the authority of consensus conferences. Evidence-based medicine has transformed both medical research and clinical medicine in many positive ways, but it has also been accused of creating an intellectual hegemony that has marginalized crucial stages of scientific research, particularly scientific discovery. Translational medicine is understood as a response to the shortfalls of both consensus conferences and evidence-based medicine. Narrative medicine is the most prominent recent development in the medical humanities. Its central claim is that attention to narrative is essential for patient care. Solomon argues that the differences between narrative medicine and the other methods have been exaggerated, and offers a pluralistic account of how the all the methods interact and sometimes conflict. The result is both practical and theoretical suggestions for how to improve medical knowledge and understand medical controversies.
The Illusion of Evidence-Based Medicine by Jon Jureidini,Leemon B. Mchenry Pdf
An expose of the corruption of medicine by the pharmaceutical industry at every level, from exploiting the vulnerable destitute for drug testing, through manipulation of research data, to disease mongering and promoting drugs that do more harm than good. Authors, Professor Jon Jureidini and Dr Leemon McHenry, made critical contributions to exposing the scientific misconduct in two infamous trials of antidepressants. Ghostwritten publications of these trials were highly influential in prescriptions of paroxetine (Paxil) and citalopram (Celexa) in paediatric and adolescent depression, yet both trials (Glaxo Smith Kline's paroxetine study 329 and Forest Laboratories' citalopram study CIT-MD-18) seriously misrepresented the efficacy and safety data. The Illusion of Evidence-Based Medicine provides a detailed account of these studies and argues that medicine desperately needs to re-evaluate its relationship with the pharmaceutical industry. Without a basis for independent evaluation of the results of randomised, placebo-controlled clinical trials, there can be no confidence in evidence-based medicine. Science demands rigorous, critical examination and especially severe testing of hypotheses to function properly, but this is exactly what is lacking in academic medicine. 'The Illusion of Evidence-Based Medicine is a brilliant expose of the negative influence of the global pharmaceutical industry on the integrity of medicine. Every medical student, doctor and patient should read this account of the ways in which medical evidence is distorted to meet the needs of Big Pharma for profits. Importantly the book points to ways in which medicine's independence can be reclaimed through improved governance and public funding.' - Professor Fran Baum
Author : John E. Snyder,Candace C. Gauthier Publisher : Springer Science & Business Media Page : 277 pages File Size : 55,8 Mb Release : 2008-10-09 Category : Medical ISBN : 9781603272469
Evidence-Based Medical Ethics: by John E. Snyder,Candace C. Gauthier Pdf
In the modern practice of medicine, new challenges complicate the ethical care of patients. Today’s times require a contemporary take on the concept of medical ethics. The idea for this textbook was born out of a need for a teaching resource that merges medical ethics theory with the practical needs of modern clinical medicine. In Evidence-Based Medical Ethics: Cases for Practice-Based Learning, the authors address what has been missing in existing text books and ethics courses to date – clear-cut ethical and legal guidelines that provide a method for the reader to learn how to systematically manage dilemmas seen in the everyday practice of medicine. The reader is guided through several "typical" patient scenarios and prompted by various questions that should be entertained by the treating health care provider. Then, relevant evidence-based medicine, legal precedent, and the ethical theory that applies to the situation are revealed. Often, finding the "best" ethical solution for each problem is automatic, as the solution often becomes self-evident during information-gathering. This general method is reinforced throughout the text with multiple different cases, using a practice-based approach by building on the reader’s developing skills. Additionally, we have sought to emphasize a culturally competent manner in resolving these dilemmas, respectfully addressing issues of age, gender, and culture whenever possible. The main goal of Evidence-Based Medical Ethics: Cases for Practice-Bases Learning is to assist the reader in adapting a patient-centered and evidence-based approach to dilemmas faced in their future practice of medicine.
This book sheds light on important philosophical assumptions made by professionals working in clinical and research medicine. In doing so, it aims to make explicit how active philosophy is in medicine and shows how this awareness can result in better and more informed medical research and practice. It examines: what features make something a scientific discipline; the inherent tensions between understanding medicine as a research science and as a healing practice; how the “replication crisis” in medical research asks us to rethink the structure of knowledge production in our modern world; whether explanations have any real scientific values; the uncertainties about probabilistic claims; and whether it is possible for evidence-based medicine to truly be value free. The final chapter argues that the most important question we can ask is not, “How can we separate values from science?” but, “In a democratic society, how can we decide in a politically and morally acceptable way what values should drive science?” Key features: introduces complex philosophical issues in a manner accessible to non-professional academics; critically examines philosophical assumptions made in medicine, providing a better understanding of medicine that can lead to better healthcare; integrates medical examples and historic contexts so as to frame the rationale of philosophical views and provide lively illustrations of how philosophy can impact science and our lives; uses inter-connected chapters to demonstrate that disparate philosophical concepts are deeply related (e.g., it shows how the aims of medicine inform how we should understand theoretical reasoning).
Philosophy of Medicine asks two central questions about medicine: what is it, and what should we think of it? Philosophy of medicine itself has evolved in response to developments in the philosophy of science, especially with regard to epistemology, positioning it to make contributions that are medically useful. This book locates these developments within a larger framework, suggesting that much philosophical thinking about medicine contributes to answering one or both of these two guiding questions. Taking stock of philosophy of medicine's present place in the landscape and its potential to illuminate a wide range of areas, from public health to policy, Alex Broadbent introduces various key topics in the philosophy of medicine. The first part of the book argues for a novel view of the nature of medicine, arguing that medicine should be understood as an inquiry into the nature and causes of health and disease. Medicine excels at achieving understanding, but not at translating this understanding into cure, a frustration that has dogged the history of medicine and continues to the present day. The second part of the book explores how we ought to consider medicine. Contemporary responses, such as evidence-based medicine and medical nihilism, tend to respond by fixing high standards of evidence. Broadbent rejects these approaches in favor of Medical Cosmopolitanism, or a rejection of epistemic relativism and pluralism about medicine that encourages conversations between medical traditions. From this standpoint, Broadbent opens the way to embracing alternative medicine. An accessible and user-friendly guide, Philosophy of Medicine puts these different debates into perspective and identifies areas that demand further exploration.
Author : David Låg Tomasi Publisher : Columbia University Press Page : 510 pages File Size : 44,8 Mb Release : 2016-10-11 Category : Medical ISBN : 9783838269351
This innovative book clarifies the distinction between philosophy of medicine and medical philosophy, expanding the focus from the ‘knowing that’ of the first to the ‘knowing how’ of the latter. The idea of patient and provider self-discovery becomes the method and strategy at the basis of therapeutic treatment. It develops the concept of ‘Central Medicine’, aimed at overcoming the dichotomies of Western–Eastern medicine and Traditional–Integrative approaches. Evidence-based and patient-centered medicine are analyzed in the context of the debate on placebo and non-specific effects alongside clinical research on the patient-doctor relationship, and the interactive nature of human relationships in general, including factors such as environment, personal beliefs, and perspectives on life’s meaning and purpose. Tomasi’s research incorporates neuroscience, psychology, philosophy, and medicine in a clear, readable, and detailed way, satisfying the needs of professionals, students, and anyone who enjoys the exploration of the complexity of human mind, brain, and heart.
