What Evidence? Reflections on Better Evidence for Better Healthcare

by Rani Lill Anjum, Better Evidence for Better Healthcare Manifesto

CauseHealth offers a new ontological foundation for medicine, what we call Causal Dispositionalism (Mumford and Anjum 2011). From this perspective, better evidence would mean evidence of causation, understood as something tendential and intrinsic. Specifically, better evidence of causation would involve theoretical understanding of how and why an intervention brings about a certain effect. But we should try to develop this understanding to also include how various factors interact, for instance, what could counteract the effect, what could enforce it and what else is causally relevant for the outcome. Continue reading “What Evidence? Reflections on Better Evidence for Better Healthcare”

Better Evidence for Better Healthcare Manifesto: the CauseHealth Perspective.

The “Better Evidence for Better Healthcare Manifesto” initiative was recently launched by the Oxford Centre for Evidence Based Medicine (CEBM) in collaboration with the British Medical Journal (BMJ).

The manifesto is motivated by a series of problems and blind spots in the implementation of EBM: lack of high quality evidence, systematic research errors, under-reporting of harm, insufficient inclusion of patient’s priorities are some of the issues named by the Manifesto’s promoters. The purpose of the initiative is to spot what could be changed and how, in order to improve the current situation. Continue reading “Better Evidence for Better Healthcare Manifesto: the CauseHealth Perspective.”

Evidence synthesis in pharmacology

By Elena Rocca

Pharmacology is a complex science that aims to balance harm and benefit of treatments for the individual patient. How should different types of evidence be synthesised in order to optimize this task? Should evidence from randomized trials be prioritized over other evidence, following the EBM model? If not, how can different types of evidence be amalgamated in an alternative way? Continue reading “Evidence synthesis in pharmacology”

What is the form of causation in health and disease, and intervention?

By David Evans

In a paper with a very long title, recently published in Medicine Health Care and Philosophy, Roger Kerry, Nic Lucas and I set out some ideas about how causation applies to relationships between health and disease. In particular, we focused on how treatment (intervention) might act to limit disease and restore health. Continue reading “What is the form of causation in health and disease, and intervention?”

Thinking about guidelines

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National Geographic Wild, Trafalgar Square in London, January 28, 2016.

On October 24, 2016, the CauseHealth crowd met with a small group of other philosophers, healthcare practitioners, and members of the guidelines community. We had a rousing discussion that lasted the whole day, with few pauses and enthusiastic participation from all in attendance. We talked about several issues with how guidelines are developed and implemented and how we thought philosophy could be relevant in solving those issues.

It is difficult to summarize the discussion in a few words—the topics were wide-ranging and participants shared complex ideas from multiple perspectives. I’m going to highlight here some of the themes that came up more than once, and to give an idea of where the group thought the discussion should go next.

Read more of Samantha’s review of the workshop
Read Rani on Real v. Ideal Guidelines
Read Elena on How Decisions are Made
Read Karin on the Ethics of Reduction
Read Stephen on the Notion of Guideline
Read Roger on the Challenges to Come
Read Fiona on Guidelines in Situ
Read Sarah on Truth, Simplicity and Personalization
Read Anna Luise on Challenging Multi-Morbidity
Read Stephen on Standards for Regulation
Read Samantha on Analogies and High-Stakes Inferences
Continue reading “Thinking about guidelines”

Reductionism isn’t enough for public health

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Chinese medical poster, 1933 (ref US NLM; image source here)

By Håkon Boman Andresen

The overarching goal of the public health sciences is to increase the population’s health. Society spends a lot of money each year on health research, which again is used to develop public policies and guidelines. However, is this causing the population to have better health? Continue reading “Reductionism isn’t enough for public health”

New article by CauseHealth collaborator Roger Kerry

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by Elena Rocca

Our friend and collaborator Roger Kerry co-authored the article “Time, space and form: Necessary for causation in health, disease and intervention?” published in this month’s issue of the journal Medicine, Health Care and Philosophy. Continue reading “New article by CauseHealth collaborator Roger Kerry”

Why do we care about the foundations of evidence-based medicine (“EBM”)?

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Photo via Latvian Ethnographic Open Air Museum

by Samantha Copeland

CauseHealth has been pushing buttons all over the place, lately, as we pursue our goal of critiquing current frameworks in EBM by proposing some deep questions about its ontology*. We aren’t the only ones—at recent events, we have found people from various communities in medicine are ready and willing to raise and engage some tough questions, about what evidence is and how it might best be used. Reflecting on two recent events we attended, in this blog post I want to think a little bit about the relationship between understanding the foundations of EBM, and putting the ideals of EBM to work for us in medical practice. Continue reading “Why do we care about the foundations of evidence-based medicine (“EBM”)?”

PhD thesis on serendipity wins award

Samantha Marie Copeland
Samantha Marie Copeland

Philosopher and CauseHealth Postdoc, Samantha Copeland, has won one of two Best Thesis Awards from Dalhousie University for her doctoral thesis The Case of the Triggered Memory: Serendipitous Discovery and the Ethics of Clinical Research. She has also been selected as their nominee for the Canadian Association for Graduate Studies Distinguished Dissertation Award in Fine Arts, Humanities and Social Sciences for 2016. Congratulations! Read more about her work on serendipity and get the full text version of the thesis.