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Evidence-based Knowledge Synthesis and Hypothesis Validation: Navigating Biomedical Knowledge Bases via Explainable AI and Agentic Systems
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Epistemologic inquiries in evidence-based medicine.
Benjamin Djulbegovic1, Gordon H Guyatt, Richard E Ashcroft
1Center for Evidence-Based Medicine and Health Outcomes Research and the Clinical Translational Science Institute at the University of South Florida, Tampa, Florida 33612, USA. bdjulbeg@health.usf.edu
Cancer Control : Journal of the Moffitt Cancer Center
|April 2, 2009
Summary
Evidence-based medicine (EBM) is not a new theory but an evolving heuristic for practice. It integrates various philosophical traditions of scientific evidence without a rigid epistemological stance.
Area of Science:
- Philosophy of Science
- Medical Epistemology
- Evidence-Based Practice
Background:
- Evidence-based medicine (EBM), since its 1991 inception, has gained global acceptance but faces criticism for a narrow evidence concept and naive theory-practice links.
- Critics argue EBM discredits traditional medical knowledge in favor of large-scale clinical trials, framing it as an epistemological system defining scientific conduct.
Purpose of the Study:
- To challenge critical views of EBM by examining its place within broader philosophy of science epistemological debates.
- To analyze EBM's relationship with classical debates on the nature of science and knowledge.
Main Methods:
- Examined EBM within major epistemological theories (logical-positivism, inductivism, deductivism, falsificationism, explanationism, instrumentalism, underdetermination).
- Investigated the philosophical underpinnings of how evidence is used in medicine.
Main Results:
- EBM aligns with "rational thinkers respect their evidence," guiding decisions and serving as a truth guide and arbiter.
- Analysis reveals EBM lacks a rigorous epistemological stance, drawing from diverse philosophical theories of scientific evidence.
Conclusions:
- Evidence-based medicine (EBM) should not be viewed as a novel scientific or philosophical theory.
- EBM is best understood as a dynamic, evolving heuristic framework designed to optimize clinical practice.
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