Introduction

Author(s):  
Jacob Stegenga

This chapter introduces the book, describes the key arguments of each chapter, and summarizes the master argument for medical nihilism. It offers a brief survey of prominent articulations of medical nihilism throughout history, and describes the contemporary evidence-based medicine movement, to set the stage for the skeptical arguments. The main arguments are based on an analysis of the concepts of disease and effectiveness, the malleability of methods in medical research, and widespread empirical findings which suggest that many medical interventions are barely effective. The chapter-level arguments are unified by our best formal theory of inductive inference in what is called the master argument for medical nihilism. The book closes by considering what medical nihilism entails for medical practice, research, and regulation.

2020 ◽  
pp. 86-88
Author(s):  
Bishan Basu

Evidence-Based Medicine (EBM) came into fashion nearly three decades ago. However, over this short period, this system of medical philosophy has come to dominate the medical practice worldwide. Never in the history of medicine could a single way of medical practice could dominate the healthcare systems of diverse countries like EBM did, that too within such short time span. But, it is high time we should ponder over the pros and cons of EBM and if this way of medical practice is to be allowed to continue, we should consider integration of additional inputs from the traditional ways of medicine. Though article focusses upon the cancer care, the conclusions derived can be applied to any other disciplines of healthcare.


Author(s):  
Jon Williamson

The EBM+ programme is an attempt to improve the way in which present-day evidence-based medicine (EBM) assesses causal claims: according to EBM+, mechanistic studies should be scrutinised alongside association studies. This paper addresses two worries about EBM+: (i) that it is not feasible in practice, and (ii) that it is too malleable, i.e., its results depend on subjective choices that need to be made in order to implement the procedure. Several responses to these two worries are considered and evaluated. The paper also discusses the question of whether we should have confidence in medical interventions, in the light of Stegenga's arguments for medical nihilism.


Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 31-31
Author(s):  
Juliana Rocha ◽  
Renata L Stanzione ◽  
Gabriela Fernandes Aranha ◽  
Dida Capobianco ◽  
Jose Claudio Cyrineu Terra ◽  
...  

Introduction: The SARS-COV2 pandemic has transformed several aspects of our daily lives, we have already experienced profound changes in our society and behavior, and it was only possible to keep part of the gear of life functioning thanks to technology. But it is not possible to talk about technology without talking about digital transformation. The technology applied to medicine provides health professionals with greater access to information and tools that convey evidence-based medicine are essential. Among them we can mention databases such as Medline, PubMed, Embase, Cochrane and UpToDate platform. The COVID 19 pandemic has further accelerated this digital transformation process, instituting changes that are here to stay. Objectives: Today in Brazil, we have an average of 7,000 oncologists and 3,000 hematologists. We know that access to information in a foreign language, even English, is still a problem. The excess of information, and the difficulty of reading scientific publications critically, are another obstacle in medical education in a developing country. The objective of this project is to expand access to information, in continues medical education model, to improve public and private health in the area of hematology. Methods: The hematology team at Hospital Israelita Albert Einstein (HIAE), associated with the HIAE digital transformation laboratory, developed a healthtech platform, called hematolog.app, aiming to make available several updated technical content in different formats: podcasts, videos , discussion of clinical cases, analysis of scientific articles in the form of visual abstracts, reviews of relevant topics in text format. The initiative is supported by the most important national hematology Societies. Discussion: We know that healthtech platforms have transformed medical practice. An online survey of clinicians at the Massachusetts General Hospital and Brigham and Women's Hospital described the following effects among UpToDate users: 95% reported that UpToDate was integral for making decisions, 94% reported that they had changed diagnosis, 95% reported that UpToDate led to a change in patient management, 97% said UpToDate helps them provide the best care for their patients, 90% reported that UpToDate makes them a better doctor, 96% reported made them more comfortable with their decisions. PubMed makes it possible to identify references and summaries of articles from the Medline database, maintained by the National Library of Medicine. PubMed provides several tools to make the search more efficient, unknown to most doctors. Conclusion: The development of hematolog.app aims to create a digital platform that integrates specialists in the area, creating a continuous process of education, and integrating professionals in a developing country, seeking to standardize medical practice in different regions and health services in Brazil, creating an interconnected social network and practicing evidence-based medicine. Disclosures No relevant conflicts of interest to declare.


2007 ◽  
Vol 137 (4_suppl) ◽  
pp. S47-S51 ◽  
Author(s):  
Martin J. Burton

Otolaryngologists and head and neck surgeons have not always fully engaged with the evidence-based medicine (EBM) movement. Now that EBM has been identified as one of the most important milestones in medicine in the last 150 years, I hope things will change. In reviewing the tenets of EBM and considering its implementation I explain why we must embrace its principles and argue that optimal medical practice is both “evidence” – and “wisdom”-based, both being necessary but neither alone being sufficient.


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