Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-26T07:04:10.381Z Has data issue: false hasContentIssue false

What Evidence in Evidence-Based Medicine?

Published online by Cambridge University Press:  01 January 2022

John Worrall*
Affiliation:
London School of Economics
*
Send requests for reprints to John Worrall, Department of Philosophy, Logic and Scientific Method, London School of Economics, London WC2A 2AE, U.K.; [email protected].

Abstract

Evidence-Based Medicine is a relatively new movement that seeks to put clinical medicine on a firmer scientific footing. I take it as uncontroversial that medical practice should be based on best evidence—the interesting questions concern the details. This paper tries to move towards a coherent and unified account of best evidence in medicine, by exploring in particular the EBM position on RCTs (randomized controlled trials).

Type
Research Article
Copyright
Copyright © The Philosophy of Science Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Benson, K., and Hartz, A. J. (2000), “A Comparison of Observational Studies and Randomised, Controlled Trials”, A Comparison of Observational Studies and Randomised, Controlled Trials 342:18781886.Google Scholar
Black, N. (1996), “Why We Need Observational Studies to Evaluate the Effectiveness of Health Care”, Why We Need Observational Studies to Evaluate the Effectiveness of Health Care 312:12151218.Google ScholarPubMed
Byer, D. P. et al. (1976), “Randomized Clinical Trials: Perspectives on Some Recent Ideas”, Randomized Clinical Trials: Perspectives on Some Recent Ideas 295 (2): 7480..Google Scholar
Chalmers, T. C., Matta, R. J., Smith, H. Jr., and Kunzler, A.M. (1977), “Evidence Favoring the Use of Anticoagulants in the Hospital Phase of Acute Myocardial InfarctionNew England Journal of Medicine 297:10911096.CrossRefGoogle ScholarPubMed
Chalmers, T. C., Celano, P., Sacks, H. S., and Smith, H. Jr. (1983), “Bias in Treatment Assignment in Controlled Clinical Trials”, Bias in Treatment Assignment in Controlled Clinical Trials 309:13581361.Google ScholarPubMed
Cochrane, A. I. (1972), Effectiveness and Efficiency. Random Reflections on the Health Service. Oxford: The Nuffield Provincial Hospitals Trust.Google Scholar
Concato, J., Shah, N., and Horwitz, R. I. (2000), “Randomised Controlled Trials, Observational Studies, and the Hierarchy of Research Designs”, Randomised Controlled Trials, Observational Studies, and the Hierarchy of Research Designs 342:18871892.Google ScholarPubMed
Doll, R., and Peto, R. (1980), “Randomised Controlled Trials and Retrospective Controls”, Randomised Controlled Trials and Retrospective Controls 280: 44.Google ScholarPubMed
Fisher, R. A. (1947), The Design of Experiments, 4th ed. Edinburgh: Oliver and Boyd.Google Scholar
Giere, R. N. (1979), Understanding Scientific Reasoning. New York: Holt, Rinehart and Winston.Google Scholar
Gore, S. M. (1981), “Assessing Clinical Trials—Why Randomise?”, Assessing Clinical Trials—Why Randomise? 282:19581960.Google ScholarPubMed
Grage, T. B., and Zelen, M. (1982), “The Controlled Randomised Trial in the Evaluation of Cancer Treatment—the Dilemma and Alternative Designs”, The Controlled Randomised Trial in the Evaluation of Cancer Treatment—the Dilemma and Alternative Designs 70:2347.Google Scholar
Howson, C., and Urbach, P. M. (1993), Scientific Reasoning — the Bayesian Approach, 2nd ed. Chicago and La Salle: Open Court.Google Scholar
Kunz, R., and Oxman, A. D. (1998), “The Unpredictability Paradox: Review of Empirical Comparisons of Randomised and Non-Randomised Clinical Trials”, The Unpredictability Paradox: Review of Empirical Comparisons of Randomised and Non-Randomised Clinical Trials 317:11851190.Google ScholarPubMed
Lelorier, J. et al. (1997), “Discrepancies between Meta-Analyses and Subsequent Large Randomised Controlled Trials”, Discrepancies between Meta-Analyses and Subsequent Large Randomised Controlled Trials 337:536542.Google Scholar
Lindley, D. V. (1982), “The Role of Randomisation in Inference”, PSA 1982, Vol. 2. East Lansing, MI: Philosophy of Science Association, 431446.Google Scholar
Papineau, D. (1994). “The Virtues of Randomisation”, British Journal for the Philosophy of Science 45:451466.CrossRefGoogle Scholar
Peto, R. et al. (1976), “Design and Analysis of Randomised Clincial Trials Requiring Prolonged Observation of Each Patient: I. Introduction and Design”, British Journal of Cancer 34:585612.CrossRefGoogle Scholar
Pocock, S. J. (1983), Clinical Trials—A Practical Approach. New York: Wiley.Google Scholar
Sackett, D. L. et al. (1995), “Clinical Practice is Evidence-Based”, Clinical Practice is Evidence-Based 350: 405–410.Google Scholar
Sackett, D. L. et al. (1996), “Evidence-Based Medicine: What It Is and What It Isn’t”, Evidence-Based Medicine: What It Is and What It Isn’t 312:7172.Google ScholarPubMed
Schwarz, D. et al. (1980), Clinical Trials. London: Academic Press.Google Scholar
Tukey, J. W. (1977), “Some Thoughts on Clinical Trials, Especially Problems of Multiplicity”, Some Thoughts on Clinical Trials, Especially Problems of Multiplicity 198:679684.Google ScholarPubMed
Urbach, P. M. (1985), “Randomisation and the Design of Experiments”, Randomisation and the Design of Experiments 52:256273.Google Scholar
Urbach, P. M. (1993), “The Value of Randomisation and Control in Clinical Trials”, The Value of Randomisation and Control in Clinical Trials 12:14211431.Google Scholar