The judgment process in evidence-based medicine and health technology assessment
Michael P Kelly a,b and Tessa A Moore c
A The National Institute for Health and Clinical Excellence, (NICE),
B General Practice and Primary Care Research Unit, Institute of Public Health,
C Head of School Effectiveness, Education, Children's and Cultural Services,
Social Theory & Health (2012) 10, 1–19. doi:10.1057/sth.2011.21; December 2011
Available online at: http://bit.ly/yiBOxB
“….This article describes the judgements used to interpret evidence in evidence-based medicine (EBM) and health technology assessment (HTA).
It outlines the methods and processes of EBM and HTA. Respectively, EBM and HTA are approaches to medical clinical decision making and efficient allocation of scarce health resources.
At the heart of both is a concern to review and synthesise evidence, especially evidence derived from randomised controlled trials (RCTs) of clinical effectiveness. The driver of the approach of both is a desire to eliminate, or at least reduce, bias.
The hierarchy of evidence, which is used as an indicator of the likelihood of bias, features heavily in the process and methods of EBM and HTA. The epistemological underpinnings of EBM and HTA are explored with particular reference to the distinction between rationalism and empiricism, developed by the philosopher David Hume and elaborated by Immanuel Kant in the Critique of Pure Reason.
The importance of Humian and Kantian principles for understanding the projects of EBM and HTA is considered and the ways in which decisions are made in both, within a judgemental framework originally outlined by Kant, are explored…..”
“….The current article adds to that thinking by suggesting that certain philosophical ideas can help to articulate or describe the judgemental and interpretive processes involved.
What this article has not considered, and which remain important areas for consideration, are the discursive and rhetorical devices used by the actors involved, the group dynamics and the way they overlay the decision-making processes…..”
* * *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues. [DD/ KMC Area]
“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
disclose, copy or distribute this transmission or take
any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.