An epistemological problem for integration in EBM

Journal of Evaluation in Clinical Practice
Sasha Lawson-Frost

Abstract

Evidence-based medicine (EBM) calls for medical practitioners to "integrate" our best available evidence into clinical practice. A significant amount of the literature on EBM takes this integration to be unproblematic, focusing on questions like how to interpret evidence and engage with patient values, rather than critically looking at how these features of EBM can be implemented together. Other authors have also commented on this gap in the literature, for example, identifying the lack of clarity about how patient preferences and evidence from trials is supposed to be integrated in practice. In this paper, I look at this issue from an epistemological perspective, (looking at how different types of knowledge in EBM can be used to make sounds judgements). In particular, I introduce an epistemological issue for this integration problem, which I call the epistemic integration problem. This is essentially the problem of how we can use information that is both general (eg, about a population sample) and descriptive (eg, about what expected outcomes are) to reach clinical judgements that are individualized (applying to a particular patient) and normative (about what is best for their health).

References

Jan 1, 1979·Journal of Chronic Diseases·D L Sackett
Nov 4, 1992·JAMA : the Journal of the American Medical Association·UNKNOWN Evidence-Based Medicine Working Group
Jan 13, 1996·BMJ : British Medical Journal·D L SackettW S Richardson
Jan 16, 1998·The American Journal of Medicine·A R Feinstein, R I Horwitz
Jul 22, 2005·International Journal of Clinical Practice·Graham Jackson
May 26, 2006·Journal of Evaluation in Clinical Practice·Mark R Tonelli
Mar 1, 2007·Academic Medicine : Journal of the Association of American Medical Colleges·Stephen G HenryRobert S Dittus
Nov 23, 2010·Journal of Evaluation in Clinical Practice·Cathy CharlesEmily Freeman
Oct 16, 2015·BMC Medical Ethics·Michael P KellyTrisha Greenhalgh
Jun 25, 2016·Evidence-based Medicine·M Hassan MuradFares Alahdab
Jun 7, 2017·Zeitschrift für Psychosomatische Medizin und Psychotherapie·David Riedl, Gerhard Schüßler
Jan 10, 2018·Journal of Evaluation in Clinical Practice·Mathew MercuriRoss E G Upshur
Jul 1, 2018·BMJ Evidence-based Medicine·Jeffrey K AronsonAnnette Plüddemann
Jul 17, 2018·Journal of Evaluation in Clinical Practice·Mathew Mercuri, Amiram Gafni
Jul 18, 2018·Journal of Evaluation in Clinical Practice·Mathew Mercuri, Amiram Gafni
Aug 2, 2018·Journal of Evaluation in Clinical Practice·Mathew Mercuri, Amiram Gafni

❮ Previous
Next ❯

Citations

Nov 17, 2019·Journal of Evaluation in Clinical Practice·Michael LoughlinK W M Fulford

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Nihon Jibiinkoka Gakkai kaiho
H Oigi
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
Justyna Felcenloben, Andrzej Gerstenkorn
Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association
Hans B KerstenAngelo P Giardino
© 2022 Meta ULC. All rights reserved