On Monday 23rd November, Stephen Mumford and Roger Kerry gave a two-part lecture at the Council for Allied Health Professions Research London Hub – Evening Lecture. The topic was ‘What is Science and Why do Health Professionals Need to Know?’. Handouts and a podcast from the event are available here.
The question was addressed first from a philosophical perspective by Stephen and then applied to evidence-based practice and clinical decision-making by Roger.
Stephen started by exploring what science is, and what distinguishes science from non-science. He then outlined some scientific methods used to understand causation; what causes what. Stephen argued that since causation is a primitive matter and cannot be analysed into something else, scientific methods can only be used to look for symptoms of causation: regularities, difference-makers, probability-raisers, and so on. But none of these are themselves sufficient or necessary for causation, so we cannot conclude from the results we get from applying these methods that causation is demonstrated or rejected.
After this, Roger opened a discussion on the role of science within evidence-based practice and on the value and limits of empirical research data when used in clinical decision making. Evidence-based clinical guidelines don’t support use of interventions that are not demonstrated to be effective for the purpose. Still, practitioners often use their own experience and knowledge to help their patients. Roger demonstrated this point by showing a video of a physiotherapist helping a patient walk down some stairs by walking backwards in front of him. When the patient took a bit of a stumble, the physiotherapist held her hands up to prevent him from falling. Was this the right thing to do, given that there are no studies that confirm that this intervention is effective?