The Evidence that Evidence-based Medicine Omits

Abstract

According to current hierarchies of evidence for EBM, evidence of correlation (e.g., from RCTs) is always more important than evidence of mechanisms when evaluating and establishing causal claims. We argue that evidence of mechanisms needs to be treated alongside evidence of correlation. This is for three reasons. First, correlation is always a fallible indicator of causation, subject in particular to the problem of confounding; evidence of mechanisms can in some cases be more important than evidence of correlation when assessing a causal claim. Second, evidence of mechanisms is often required in order to obtain evidence of correlation (for example, in order to set up and evaluate RCTs). Third, evidence of mechanisms is often required in order to generalise and apply causal claims. While the EBM movement has been enormously successful in making explicit and critically examining one aspect of our evidential practice, i.e., evidence of correlation, we wish to extend this line of work to make explicit and critically examine a second aspect of our evidential practices: evidence of mechanisms.

Other Versions

No versions found

Links

PhilArchive

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

  • Only published works are available at libraries.

Similar books and articles

Introduction.Jon Williamson, Beth Shaw, Federica Russo, Charles Norell, Michael Kelly, Phyllis Illari, Brendan Clarke, Michael Wilde, Christian Wallmann & Veli-Pekka Parkkinen - 2018 - In Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly, Charles Norell, Federica Russo, Beth Shaw & Jon Williamson, Evaluating evidence of mechanisms in medicine. Dordrecht, Netherlands: Springer. pp. 3-9.
Applying Evidential Pluralism to the Social Sciences.Yafeng Shan & Jon Williamson - 2021 - European Journal for Philosophy of Science 11 (4):1-27.
Mechanisms: what are they evidence for in evidence-based medicine?Holly Andersen - 2012 - Journal of Evaluation in Clinical Practice 18 (5):992-999.
Mechanistic Evidence: Disambiguating the Russo–Williamson Thesis.Phyllis McKay Illari - 2011 - International Studies in the Philosophy of Science 25 (2):139-157.

Analytics

Added to PP
2013-11-22

Downloads
176 (#231,412)

6 months
27 (#364,047)

Historical graph of downloads
How can I increase my downloads?

Author Profiles

Brendan Clarke
University College London
Donald Gillies
University College London
2 more

Citations of this work

Evaluating evidence of mechanisms in medicine.Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly, Charles Norell, Federica Russo, Beth Shaw & Jon Williamson - 2018 - Dordrecht, Netherlands: Springer. Edited by Brendan Clarke, Phyllis Illari, Michael P. Kelly, Charles Norell, Federica Russo, Beth Shaw, Christian Wallmann, Michael Wilde & Jon Williamson.
Establishing Causal Claims in Medicine.Jon Williamson - 2019 - International Studies in the Philosophy of Science 32 (1):33-61.
Reframing the environment in data-intensive health sciences.Stefano Canali & Sabina Leonelli - 2022 - Studies in History and Philosophy of Science Part A 93 (C):203-214.

View all 57 citations / Add more citations

References found in this work

No references found.

Add more references