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Evidence-based medicine as science.

Joseph Vere1, Barry Gibson2

  • 1Department of Orthodontics and Restorative Dentistry, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.

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|December 22, 2018
PubMed
Summary
This summary is machine-generated.

Evidence-based medicine (EBM) claims to be scientific, but this paper argues it does not align with established philosophy of science theories. EBM

Keywords:
Kuhnian paradigmepistemologyevidence-based medicinefalsificationisminductivismresearch programme

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Area of Science:

  • Philosophy of Science
  • Medical Epistemology

Background:

  • Evidence-based medicine (EBM) frequently asserts its status as a scientific discipline.
  • The philosophical underpinnings of scientific methodology are historically categorized into inductivism, falsificationism, Kuhnian paradigms, and research programmes.
  • The validity of EBM's scientific claims necessitates alignment with these recognized theories of science.

Purpose of the Study:

  • To critically evaluate whether the knowledge claims within evidence-based medicine (EBM) are justified according to major theories of science.
  • To reframe the claim of EBM as science by focusing on knowledge derived from randomized controlled trials and meta-analyses.
  • To analyze EBM's core tenets through the lenses of inductivism, falsificationism, Kuhnian paradigms, and research programmes.

Main Methods:

  • Introduction of four major theories of scientific nature: inductivism, falsificationism, Kuhnian paradigms, and research programmes.
  • Reinterpretation of EBM's scientific claim, focusing on knowledge derived from randomized controlled trials and meta-analyses.
  • Analysis of EBM's valued knowledge claims against the established philosophical theories of science.

Main Results:

  • Knowledge claims central to evidence-based medicine (EBM) are not demonstrably justified through inductivism.
  • EBM's knowledge claims do not align with the principles of falsificationism.
  • The methodologies and knowledge claims of EBM are inconsistent with Kuhnian paradigms and research programmes.

Conclusions:

  • Evidence-based medicine (EBM) does not meet the criteria of established philosophy of science theories, challenging its claim to be science.
  • The justification of knowledge within EBM requires re-evaluation in light of recognized scientific methodologies.
  • If inductivism, falsificationism, Kuhnian paradigms, and research programmes are the benchmarks for science, EBM falls short.