Medicine

What Evidence? Reflections on Better Evidence for Better Healthcare

by Rani Lill Anjum, Better Evidence for Better Healthcare Manifesto

CauseHealth offers a new ontological foundation for medicine, what we call Causal Dispositionalism (Mumford and Anjum 2011). From this perspective, better evidence would mean evidence of causation, understood as something tendential and intrinsic. Specifically, better evidence of causation would involve theoretical understanding of how and why an intervention brings about a certain effect. But we should try to develop this understanding to also include how various factors interact, for instance, what could counteract the effect, what could enforce it and what else is causally relevant for the outcome. (more…)

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Evidence synthesis in pharmacology

By Elena Rocca

Pharmacology is a complex science that aims to balance harm and benefit of treatments for the individual patient. How should different types of evidence be synthesised in order to optimize this task? Should evidence from randomized trials be prioritized over other evidence, following the EBM model? If not, how can different types of evidence be amalgamated in an alternative way? (more…)

What is the form of causation in health and disease, and intervention?

By David Evans

In a paper with a very long title, recently published in Medicine Health Care and Philosophy, Roger Kerry, Nic Lucas and I set out some ideas about how causation applies to relationships between health and disease. In particular, we focused on how treatment (intervention) might act to limit disease and restore health. (more…)

Thinking about guidelines

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National Geographic Wild, Trafalgar Square in London, January 28, 2016.

On October 24, 2016, the CauseHealth crowd met with a small group of other philosophers, healthcare practitioners, and members of the guidelines community. We had a rousing discussion that lasted the whole day, with few pauses and enthusiastic participation from all in attendance. We talked about several issues with how guidelines are developed and implemented and how we thought philosophy could be relevant in solving those issues.

It is difficult to summarize the discussion in a few words—the topics were wide-ranging and participants shared complex ideas from multiple perspectives. I’m going to highlight here some of the themes that came up more than once, and to give an idea of where the group thought the discussion should go next.

Read more of Samantha’s review of the workshop
Read Rani on Real v. Ideal Guidelines
Read Elena on How Decisions are Made
Read Karin on the Ethics of Reduction
Read Stephen on the Notion of Guideline
Read Roger on the Challenges to Come
Read Fiona on Guidelines in Situ
Read Sarah on Truth, Simplicity and Personalization
Read Anna Luise on Challenging Multi-Morbidity
Read Stephen on Standards for Regulation
Read Samantha on Analogies and High-Stakes Inferences
(more…)

New CauseHealth publication about risk assessment of drugs.

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In Bridging the Boundaries Between Scientists and Clinicians, Elena Rocca explores the field of drug risk assessment as an example of strict interdependence between basic biomedical research, clinical research, and clinical evaluation and shows how it would benefit from a closer collaboration between scientists and clinicians. (more…)

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Re-Thinking Preclinical Research

How efficient is it really to exclude individual variability, context sensitivity and plurality of causes from lab models?

by Elena Rocca

Faith in medical research has decreased recently. Despite all the expectations of ‘personalized medicine’ and ‘tailored drug research’ since the dawn of the post genomic era, pre-clinical medical research has remained pretty much the same. (more…)