- Title
- EBM: a narrow and obsessive methodology that fails to meet the knowledge needs of a complex adaptive clinical world: a commentary on Djulbegovic, B., Guyatt, G. H. & Ashcroft, R. E. (2009) Cancer Control, 16, 158-168 (commentary)
- Creator
- Sturmberg, Joachim P.
- Relation
- Journal of Evaluation in Clinical Practice Vol. 15, Issue 6, p. 917-923
- Publisher Link
- http://dx.doi.org/10.1111/j.1365-2753.2009.01321.x
- Publisher
- Wiley-Blackwell Publishing
- Resource Type
- journal article
- Date
- 2009
- Description
- Benjamin Djulbegovic, Gordon H. Guyatt and Richard E. Ashcroft in their recent paper ‘Epistemologic inquiries in evidence-based medicine’, attempt to justify evidence-based medicine (EBM) from an epistemological framework. Because EBM proposes a specific relationship between theory, evidence, and knowledge, its theoretical basis can be understood as an epistemological system. Djulbegovic, Guyatt and Ashcroft’s assertion that EBM has a normative function is incongruent with their conclusion that EBM is a heurist, a technique or a ‘rule of thumb’. ‘Evidence’ understood in this sense can neither be prescriptive nor deterministic in the particular. EBM can no longer either assert or imply a special authority in clinical practice and clinical decision making. As a ‘heuristic’, EBM is an idiot savant, a perfection of technique, but confusion in ends. Perfect population-level probabilities have no deterministic probability at the individual level, a point emphasized by many critics.
- Subject
- evidence-based medicine (EBM); epistemological; heuristic; clinical
- Identifier
- http://hdl.handle.net/1959.13/807661
- Identifier
- uon:7468
- Identifier
- ISSN:1356-1294
- Language
- eng
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