Evidence-based medicine (EBM) has become a required element of clinical practice, but it is critical for the healthcare community to understand the ongoing controversy surrounding EBM. Seeking to address questions raised by critics, The Philosophy of Evidence-based Medicine challenges the over dependency of EBM on randomized controlled trials. This book also explores EBM methodology and its relationship with other approaches used in medicine.

Evidence-based medicine (EBM) has become a required element of clinical practice, but it is critical for the healthcare community to understand the ongoing controversy surrounding EBM. Seeking to address questions raised by critics, The Philosophy of Evidence-based Medicine challenges the over dependency of EBM on randomized controlled trials. This book also explores EBM methodology and its relationship with other approaches used in medicine.

Internationally recognized experts, pioneers, and opinion makers in evidence-based medicine (EBM) provocatively recast endocrine policy and practice in the light of EBM philosophy and principles. The authors explain the past, present, and future of EBM; consider its practical implications for endocrinology; demonstrate what the "evidence base" is in EBM; and present illustrative case studies by practicing evidence-based clinicians. Highlights include essays on why cost-effective analyses are problematic, the contrast between clinical investigations and large randomized trials, the role of Cochrane reviews and meta-analyses, and the curriculum requirements for training evidence-based endocrinologists.

This open access book describes and illustrates the surgical techniques, implants, and technologies used for the purpose of personalized implantation of hip and knee components. This new and flourishing treatment philosophy offers important benefits over conventional systematic techniques, including component positioning appropriate to individual anatomy, improved surgical reproducibility and prosthetic performance, and a reduction in complications. The techniques described in the book aim to reproduce patients’ native anatomy and physiological joint laxity, thereby improving the prosthetic hip/knee kinematics and functional outcomes in the quest of the forgotten joint. They include kinematically aligned total knee/total hip arthroplasty, partial knee replacement, and hip resurfacing. The relevance of available and emerging technological tools for these personalized approaches is also explained, with coverage of, for example, robotics, computer-assisted surgery, and augmented reality. Contributions from surgeons who are considered world leaders in diverse fields of this novel surgical philosophy make this open access book will invaluable to a wide readership, from trainees at all levels to consultants practicing lower limb surgery

An exposé of the corruption of medicine by the pharmaceutical industry at every level, from exploiting the vulnerable destitute for drug testing, through manipulation of research data, to disease mongering and promoting drugs that do more harm than good. Authors, Professor Jon Jureidini and Dr Leemon McHenry, made critical contributions to exposing the scientific misconduct in two infamous trials of antidepressants. Ghostwritten publications of these trials were highly influential in prescriptions of paroxetine (Paxil) and citalopram (Celexa) in paediatric and adolescent depression, yet both trials (Glaxo Smith Kline's paroxetine study 329 and Forest Laboratories' citalopram study CIT-MD-18) seriously misrepresented the efficacy and safety data. The Illusion of Evidence-Based Medicine provides a detailed account of these studies and argues that medicine desperately needs to re-evaluate its relationship with the pharmaceutical industry. Without a basis for independent evaluation of the results of randomised, placebo-controlled clinical trials, there can be no confidence in evidence-based medicine. Science demands rigorous, critical examination and especially severe testing of hypotheses to function properly, but this is exactly what is lacking in academic medicine.

The accompanying CD-ROM contains clinical examples, critical appraisals and background papers.

This volume covers a wide range of conceptual, epistemological and methodological issues in the philosophy of science raised by reflection upon medical science and practice. Several chapters examine such general meta-scientific concepts as discovery, reduction, theories and models, causal inference and scientific realism as they apply to medicine or medical science in particular. Some discuss important concepts specific to medicine (diagnosis, health, disease, brain death). A topic such as evidence, for instance, is examined at a variety of levels, from social mechanisms for guiding evidence-based reasoning such as evidence-based medicine, consensus conferences, and clinical trials, to the more abstract analysis of experimentation, inference and uncertainty. Some chapters reflect on particular domains of medicine, including psychiatry, public health, and nursing. The contributions span a broad range of detailed cases from the science and practice of medicine, as well as a broad range of intellectual approaches, from conceptual analysis to detailed examinations of particular scientific papers or historical episodes. Chapters view philosophy of medicine from quite different angles Considers substantive cases from both medical science and practice Chapters from a distinguished array of contributors

This book is open access under a CC BY license. This book is the first to develop explicit methods for evaluating evidence of mechanisms in the field of medicine. It explains why it can be important to make this evidence explicit, and describes how to take such evidence into account in the evidence appraisal process. In addition, it develops procedures for seeking evidence of mechanisms, for evaluating evidence of mechanisms, and for combining this evaluation with evidence of association in order to yield an overall assessment of effectiveness. Evidence-based medicine seeks to achieve improved health outcomes by making evidence explicit and by developing explicit methods for evaluating it. To date, evidence-based medicine has largely focused on evidence of association produced by clinical studies. As such, it has tended to overlook evidence of pathophysiological mechanisms and evidence of the mechanisms of action of interventions. The book offers a useful guide for all those whose work involves evaluating evidence in the health sciences, including those who need to determine the effectiveness of health interventions and those who need to ascertain the effects of environmental exposures.

This is an ideal introductory text on Evidence Based Medicine (EBM) for medical students and all health-care professionals.

What kind of knowledge is medical knowledge? Can medicine be explained scientifically? Is disease a scientific concept, or do explanations of disease depend on values? What is "evidence-based" medicine? Are advances in neuroscience bringing us closer to a scientific understanding of the mind? The nature of medicine raises fundamental questions about explanation, causation, knowledge and ontology – questions that are central to philosophy as well as medicine. This book introduces the fundamental issues in philosophy of medicine for those coming to the subject for the first time, including: • understanding the physician–patient relationship: the phenomenology of the medical encounter. • Models and theories in biology and medicine: what role do theories play in medicine? Are they similar to scientific theories? • Randomised controlled trials: can scientific experiments be replicated in clinical medicine? What are the philosophical criticisms levelled at RCTs? • The concept of evidence in medical research: what do we mean by "evidence-based medicine"? Should all medicine be based on evidence? • Causation in medicine. • What do advances in neuroscience reveal about the relationship between mind and body? • Defining health and disease: are explanations of disease objective or do they depend on values? • Evolutionary medicine: what is the role of evolutionary biology in understanding medicine? Is it relevant? Extensive use of empirical examples and case studies are included throughout, including debates about smoking and cancer, the use of placebos in randomised controlled trials, controversies about PSA testing and research into the causes of HIV. This is an indispensable introduction to those teaching philosophy of medicine and philosophy of science.