The EBM+ movement.

Area of Science:

• Philosophy of Medicine
• Biostatistics
• Medical Research Methodology

Background:

• Philosophical arguments challenge the Evidence-Based Medicine (EBM) approach for establishing medical causal claims.
• Recent philosophy of medicine literature suggests mechanistic studies can address these challenges.

Purpose of the Study:

• To introduce biostatisticians and others to recent work in the philosophy of medicine.
• To critically examine philosophical arguments against EBM regarding causal claims.
• To present a novel approach, EBM+, for establishing causal claims in medicine.

Main Methods:

• Overview of philosophical arguments against EBM.
• Review of literature on mechanistic studies in philosophy of medicine.
• Description of the EBM+ approach.

Main Results:

• Identification of philosophical problems for the Evidence-Based Medicine (EBM) approach.
• Demonstration of how mechanistic studies can resolve these problems.
• Introduction of the EBM+ framework for improved causal inference.

Conclusions:

• The Evidence-Based Medicine (EBM) approach faces philosophical challenges in establishing causal claims.
• Mechanistic studies offer a promising avenue to strengthen causal inference in medicine.
• The proposed EBM+ approach integrates mechanistic insights for more robust causal claims.