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

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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…

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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 is the Guidelines Challenge?

Rani Lill Anjum

CauseHealth recently organised a conference in Oxford called The Guidelines Challenge: Philosophy, Practice, Policy.

For those who missed the event, podcasts of the talks are available on our YouTube channel, and there is also a summary from each of the two days on Storify (day 1, day 2). There is also a Twitter hashtag, #GuidelinesChallenge.
Continue reading “What is the Guidelines Challenge?”

Philosophy of Pharmacology Symposium at ECAP9 (LMU Munich, Aug 2017)

WP_20170822_16_24_14_Pro_LIPart of the CauseHealth team went to ECAP9 and spoke about why deep understanding of causation, mechanisms and the local context is essential for drug safety. We were also excited to be in a session with Ralph Edwards, former Director of the Uppsala Monitoring Centre for drug safety, which acts as the official advisor for the World Health Organisation (WHO). Thanks for having us, Barbara!

PhilPharm: Safety, Statistical Standards, and Evidence Amalgamation

The symposium “Philosophy of Pharmacology: Theoretical Foundations, Methodological Evolution, and Public Health Policy” took place at LMU Munich on 22 August, 2017, as part of the Ninth Congress of Analytic Philosophy  (ECAP9) of the European Society of Analytic Philosophy (ESAP). The congress was jointly organized by Barbara Osimani, Jürgen Landes, and Roland Poellinger. The program featured contributions by four speakers:

  1. Barbara Osimani (Ancona / LMU)
  2. Rani Lill Anjum (Norwegian University)
  3. Elena Rocca (Norwegian University)
  4. Ralph Edwards (Uppsala Monitoring Centre of the World Health Organization)

At the overlap of philosophy and health science, this symposium offered a panorama of the complex network of interests found in pharmacology (financial, reputational etc.) as well as the scientific and social ecosystem in which pharmacology is embedded. A special focus was on current debates regarding 1) standards for evidence evaluation, 2) methodological evolution, and 3) pragmatics as well as epistemic asymmetry of causal assessment of risk…

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New CauseHealth paper about risk assessment of genetically modified plants

by Elena Rocca

One idea promoted by CauseHealth is that, when evaluating evidence, pre-existing theoretical frameworks count as much as the data. For instance, data from a certain trial assume a particular significance depending on the general background theoretical understanding we have when we interpret them. In this new CauseHealth article, Elena Rocca and Fredrik Andersen show that, when evaluating health risks related to the use of genetically modified plants in agriculture, different ontological starting points play an essential role for the final risk evaluation. Continue reading “New CauseHealth paper about risk assessment of genetically modified plants”

Imagination and its Companions

Author Brian Broom
(#1 of the Whole Person reflections series)

How is it possible to be whole person-oriented and still feel that our work is manageable? Surely, we can’t be all things to all people? Continue reading “Imagination and its Companions”

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?”

The Patient: The Beginning of it All

By Elena Rocca

We often think of the perfect medical research and health care system as a system that puts patient’s care as the final aim of a long process. In a way, this is hardly controversial: patient’s interest must be prioritized over commercial interest, for instance. Research hypotheses, funding, experimental designs ought to be developed with a special consideration that they are meant to be primarily useful for the patient. Important steps are being taken in this direction. Continue reading “The Patient: The Beginning of it All”

Map versus terrain?

by Anna Luise Kirkengen

When discussing the potentials and limitations of “Evidence Based Medicine”, it might be reasonable to begin by examining the premises inherent in the concept. It might be wise to question, for example, whether the use of the word “Evidence” in this model represents an improper appropriation of the term, as if it had a single, specific meaning. One might object: “What is evident? Well, that depends.” Continue reading “Map versus terrain?”

MORE ON SYMPTOMS

by Stephen Tyreman, Better Evidence for a Better Healthcare Manifesto

Most healthcare professions claim to seek and treat the causes rather than the symptoms of disease.  This started as a reaction to the medicine of the nineteenth century, which was still influenced by Humoral Theory and Paracelsus.  Treatments were given to counter the symptoms patients were experiencing.  Unfortunately, many of the heroic purgative and cathartic potions given, such as calomel, arsenic, mercury and opium, were more harmful than the diseases they were treating.  It led Hahnemann, for example, to develop homoeopathy on the opposite principle that substances that caused similar symptoms to the condition and given in small doses were more effective – but that’s another debate.  The focus today, apart, perhaps, from in palliative care, is on treating the cause, bypassing symptoms per se, or using them as monitors of healing. Continue reading “MORE ON SYMPTOMS”