EBM and the strawman: a commentary on Devisch and Murray (2009). ‘We hold these truths to be self-evident': deconstructing ‘evidence-based’ medical practice

2009 ◽  
Vol 15 (6) ◽  
pp. 957-959 ◽  
Author(s):  
Stephen Buetow
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. 6445-6446
Author(s):  
Michael Sharpe

All physicians experience situations in which they need the knowledge, skills, and attitudes commonly thought of as belonging to psychiatry. This section of the book aims to help physicians to acquire these. It includes: (1) guidance on how to assess medical patients for psychiatric illness; (2) information about psychiatric presentations and the differential diagnoses most relevant to general medical practice; (3) brief reviews of the psychiatric disorders most commonly seen in general medical practice and the practical management of these; (4) guidance on the use of psychotropic drugs and psychological treatments when given as part of general medical care; (5) evidence-based strategies for helping patients who are smoking, using alcohol excessively, or who are overweight.


2019 ◽  
Vol 24 (3) ◽  
pp. 230-238
Author(s):  
Luciana Pereira de Vasconcelos ◽  
Luiza de Oliveira Rodrigues ◽  
Moacyr Roberto Cuce Nobre

Purpose Good medical practice, evidence-based medicine (EBM) and clinical practice guidelines (CPG) have been recurring subjects in the scientific literature. EBM advocates argue that good medical practice should be guided by evidence-based CPG. On the other hand, critical authors of EBM methodology argue that various interests undermine the quality of evidence and reliability of CPG recommendations. The purpose of this paper is to evaluate patient related outcomes of CPG implementation, in light of EBM critics. Design/methodology/approach The authors opted for a rapid literature review. Findings There are few studies evaluating the effectiveness of CPG in patient-related outcomes. The systematic reviews found are not conclusive, although they suggest a positive impact of CPGs in relevant outcomes. Research limitations/implications This work was not a systematic review of literature, which is its main limitation. On the other hand, arguments from EBM and CPG critics were considered, and thus it can enlighten health institutions to recognize the caveats and to establish policies toward care improvement. Originality/value The paper is the first of its kind to discuss, based on the published literature, next steps toward better health practice, while acknowledging the caveats of this process.


2011 ◽  
Vol 17 (4) ◽  
pp. 651-656 ◽  
Author(s):  
Sarah Mozafarpour ◽  
Atefeh Sadeghizadeh ◽  
Payam Kabiri ◽  
Hajar Taheri ◽  
Manizheh Attaei ◽  
...  

2016 ◽  
Vol 4 (3) ◽  
pp. 467 ◽  
Author(s):  
Dave Newell ◽  
George Lewith

The division between orthodox and CAM approaches to musculoskeletal (MSK) problems is blurred. Manipulative medicine and acupuncture are recognized treatment options for some MSK conditions. These therapies are increasingly evidence based with well-defined mechanisms and are provided by a number of registered professional practitioners, whose ethics and practice is overseen and ultimately regulated, by the Professional Standards Authority. Some practitioners may be considered historically as CAM providers (Osteopaths, Chiropractors and Acupuncturists) and some orthodox practitioners (Physiotherapists and Doctors). If both CAM and orthodox practitioners are providing the same therapies for the same conditions, we believe that this represents good evidence based medical practice. Consequently in this situation, the historical and artificial boundaries between CAM and orthodox medicine cease to be meaningful either clinically or ethically.  We should reasonably assume that CAM and orthodox practitioners, in this context, are practicing ethically.


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