2007/11/01 by John Worrall · 1 voice · 3 citations
Decision Sciences · Health Professions · Medicine · #Clinical Reasoning and Diagnostic Skills #Healthcare cost, quality, practices #Meta-analysis and systematic reviews
paper · doi:10.1111/j.1747-9991.2007.00106.x
openalex publication_date 2007/11/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
Abstract It is surely obvious that medicine, like any other rational activity, must be based on evidence. The interest is in the details: how exactly are the general principles of the logic of evidence to be applied in medicine? Focussing on the development, and current claims of the ‘Evidence‐Based Medicine’ movement, this article raises a number of difficulties with the rationales that have been supplied in particular for the ‘evidence hierarchy’ and for the very special role within that hierarchy of randomized controlled trials (and meta‐analyses of the results of randomized controlled trials). The point is not at all to question the application of a scientific approach to evidence in medicine, but, on the contrary, to indicate a number of areas where philosophers of science can contribute to a proper implementation of exactly that scientific‐evidential approach.