Category: N=1

Living with complexity and big data. Causal dispositionalim enters pharmacovigilance

Ralph Edwards on dispositionalism in pharmacovigilance

We have seen a lot of interest in the CauseHealth approach and issues during these last years, especially among clinicians who see a need for a more person centered healthcare. Can this be useful also outside the clinic? Yes, according to senior medical advisor at the WHO Uppsala Monitoring Center for Drug Safety, Ralph Edwards. In a recent perspectives article in the UMC report, he argues that dispositionalism can be useful for dealing with complexity, individual variation and the patient’s unique context. Continue reading “Living with complexity and big data. Causal dispositionalim enters pharmacovigilance”

CauseHealth workshop N=1 is now a section in JECP special issue.

Capture

The Journal of Evaluation in Clinical Practice has dedicated a section of its latest special issue to collect seven contributions which were previously presented in the CauseHealth workshop N=1. A further contribution from the same workshop was published by the same journal last year. Continue reading “CauseHealth workshop N=1 is now a section in JECP special issue.”

What if…

fear-1131143_1920

Author Anna Luise Kirkengen
(#2 of the Whole Person reflections series)

What if one would weave a text by means of threads coloured by the recent topics of the on-going CauseHealth project. One thread would be causality, and how it is understood and applied in current biomedicine. Another would be ontology in the sense of how a human being and the human body is conceptualised in medicine and how this concept underpins the Western health care systems. A third thread would be methodology, and how the predominant methods for knowledge production, group based, randomised trials often including thousands of patients, might be radically challenged by the concept of N=1. A fourth thread would be stories in the sense of biographies before a person fell ill, and stories in the sense of testimonies of being ill – and how these have been systematically avoided as possible source of contamination in medical knowledge production. A fifth thread would then be knowledge condensates as these have grown both in number and normativity in the shape of clinical guidelines in all medical specialties during the latest years. Together, these threads can form quite different pictures, dependent on the frame applied. Continue reading “What if…”

What does CauseHealth mean by N=1?

by Roger Kerry

“N=1” is a slogan used to publicise a core purpose of the CauseHealth project. N=1 refers to a project which is focussed on understanding causally important variables which may exist at an individual level, but which are not necessarily represented or understood through scientific inquiry at a population level. There is an assumption that causal variables are essentially context-sensitive, and as such although population data may by symptomatic of causal association, they do not constitute causation. The project seeks to develop existing scientific methods to try and better understand individual variations. In this sense, N=1 has nothing at all to do with acquiescing to “what the patient wants”, or any other similar fabricated straw-man characterisations of the notion which might emerge during discussions about this notion. Continue reading “What does CauseHealth mean by N=1?”

N=1 Reflections Roundup

by Samantha CopelandDSC_0033

I’d like to shout out a hearty thank you for the last two weeks’ contributions from the
participants in our January workshop, N=1: Causal Reasoning and Evidence for Clinical Practice! A diverse group of participants has given us a variety of things to think about, compliments to savour, and tough questions to ponder—thank for making February interesting too.
Continue reading “N=1 Reflections Roundup”

The role of meaning in (medical) science

Reflections by Adam Bjerre on N=1Campus25

The CauseHealth workshop at NMBU was a very different kind of workshop than I was used to as a practising and basically mechanistically trained physiotherapist. The gathering was much more abstract, more reflective and still tremendously engaging and relevant. It occurred to me how much the workshop highlighted the problem that still seems to haunt the medical sciences as well as the sciences in general, but the natural sciences in particular: the role of meaning in a material world or more precisely how (local, not global) meaning can be causally efficacious. Continue reading “The role of meaning in (medical) science”

Prediction in medicine: philosophical reflections

Reflection by Jonathan Fuller on N=1IMG_4742

The final session of the CauseHealth N = 1 workshop explored prediction in medicine; it involved me and Alex Broadbent. Alex previously pointed out that the topic of prediction has scarcely been explored by philosophers, let alone the topic of prediction in epidemiology or medicine. Yet predictions are absolutely crucial for the practice of medicine. Continue reading “Prediction in medicine: philosophical reflections”

Learn to stop worrying and love Evidence Based Medicine

Reflection by Chris Worsfold on N=1Chris

What singular question could be more pressing for clinicians today: how do we prepare the way for the return of the P-E-R-S-O-N in contemporary healthcare amidst rife healthcare commodification and the mechanical one-size-fits-all approach that is EBM? Continue reading “Learn to stop worrying and love Evidence Based Medicine”