EBM+ augments evidence-based medicine (EBM) by providing methods to evaluate mechanistic studies alongside the association studies (such as RCTs) that are the bread and butter of EBM. There has been a lot of interesting research in recent months related to the EBM+ programme. Here’s a quick overview of some key themes.
The following paper provides a case study in virology that shows how mechanistic reasoning reinforces reasoning from association studies:
- Auker-Howlett, D. and Wilde, M. (2020). Reinforced reasoning in medicine. Journal of Evaluation in Clinical Practice 26: 458‐ 464. https://dx.doi.org/10.1111/jep.13269.
One might worry that it’s not really feasible to evaluate mechanistic studies alongside association studies. Here I attempt to dispell that worry, as well as the concern that EBM+ might be particularly open to subjective influence:
Good evidence of the feasibility of EBM+ is provided by the International Agency for Research on Cancer, whose methods are now very close to those advocated by EBM+. This paper describes the new IARC methods:
- Jonathan M Samet et al (2020): The IARC Monographs: Updated procedures for modern and transparent evidence synthesis in cancer hazard identification, Journal of the National Cancer Institute 112(1):1-8, 2020. doi: 10.1093/jnci/djz169
While this paper analyses the methods from a philosophical point of view:
- Jon Williamson: Evidential Proximity, Independence, and the evaluation of carcinogenicity, Journal of Evaluation in Clinical Practice 25(6):955-961, 2019. doi: 10.1111/jep.13226
The following paper explores IARC, EBM+ and extrapolation:
- Wilde, M. and Parkkinen, V. (2019). Extrapolation and the Russo–Williamson thesis. Synthese 196:3251-3262. https://doi.org/10.1007/s11229-017-1573-y
while this paper emphasises the importance of mechanistic evidence to extrapolation:
- Veli-Pekka Parkkinen & Jon Williamson: Extrapolating from model organisms in pharmacology, in La Caze, A., & Osimani, B., (eds), Uncertainty in pharmacology: epistemology, methods, and decisions, Springer, 2020, pp. 59-78. ISBN: 978-3-030-29178-5
There’s also the question of whether EBM+ can be extended to the social sciences. This paper argues that the social science ought to be considered to be a part of the health sciences:
This paper also creates a bridge between the health sciences and the social sciences:
- Kelly, M. P., & Russo, F. (2018). Causal narratives in public health: the difference between mechanisms of aetiology and mechanisms of prevention in non-communicable diseases. Sociology of health & illness, 40(1), 82–99. https://doi.org/10.1111/1467-9566.12621
Do you have something to say on whether EBM+ might be extended to the social sciences? If so there is a call for papers open for a topical collection of the journal Synthese, deadline 15 November 2020. Please contribute!
University of Kent