Evaluating Evidence of Mechanisms in Medicine

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 bookoffers 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.

• Evidence-based medicine
• Mechanisms in medicine
• Evaluating evidence
• Medical methodology
• Evidence hierarchy
• Philosophy of medicine
• Mechanisms in literature
• Mechanism hypothesis
• Hypothesize a mechanism
• evidence of mechanisms
• Assessing exposures
• evidence and status of claim.
• Humanities Research
• Evidence-Based Medicine (EBM)
• Molecular epidemiology
• ebmplus.org
• analogous epistemic theory
• external validity
• effects of environmental exposures
• Open access

• Department of Philosophy, University of Bergen, Bergen, Norway

  Veli-Pekka Parkkinen

• Centre for Reasoning, University of Kent, Canterbury, United Kingdom

  Christian Wallmann, Michael Wilde, Jon Williamson

• Department of Science and Technology Studies, University College London, London, United Kingdom

  Brendan Clarke, Phyllis Illari

• Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom

  Michael P Kelly

• Cancer Research UK, London, United Kingdom

  Charles Norell

• Department of Philosophy, University of Amsterdam, Amsterdam, The Netherlands

  Federica Russo

• Centre for Evidence-Based Policy, Oregon Health & Science University, Portland, USA

  Beth Shaw

The authors of this book are members of EBM+ (ebmplus.org), a network of researchers investigating the role of evidence of mechanisms in the health sciences. During the writing of this book, Parkkinen, Wallmann, Wilde and Williamson were based at the Centre for Reasoning, University of Kent; Clarke, Illari and Norell at the Department of Science and Technology Studies, UCL; Kelly at the Department of Public Health and Primary Care, University of Cambridge; Russo at the Department of Philosophy, University of Amsterdam; and Shaw at the National Institute of Health and Care Excellence, UK. This research way supported by the UK Arts and Humanities Research Council and the Leverhulme Trust.

Policies and ethics