Stats #76: The post-modern assault on evidence-based medicine

Content: This training class will discuss some philosophical criticisms of evidence based medicine.

Teaching strategies: Didactic lectures and small group exercises.

Abstract: Post-modern philosophers have been attacking many institutions that provide (from the post-modern perspective) a false sense of objectivity in their work. It was only a matter of time before they would turn their attention on evidence based practice (EBP), an approach that tries to incorporate greater use of objective research into the practice of healthcare. Their rhetoric is surprisingly harsh, but unnecessarily so. All the criticisms that post-modern writers lay at the feet of EBP are criticisms that EBP itself has been able to successfully identify. EBP is perfectly capable on its own to understand the areas where objectivity is an illusion and to take corrective action.

Objectives: In this seminar, you will learn how to:

• define the practice of evidence-based medicine,
• describe the post-modern criticisms of evidence-based medicine, and
• identify the self-acknowledged limitations of evidence-based medicine.

Notes: There are no pre-requisites for this seminar. This class does not qualify for IRB Education Credits (IRBECs).

Information about my book, Statistical Evidence in Medical Trials

I recently published a book, Statistical Evidence in Medical Trials, What do the Data Really Tell Us? through Oxford University Press. A good summary of what this book is about appears on the back cover: "Statistical Evidence in Medical Trials is a lucid, well-written and entertaining text that addresses common pitfalls in evaluating medical research. Including extensive use of publications from the medical literature and a non-technical account of how to appraise the quality of evidence presented in these publications, this book is ideal for health care professionals, students in medical or nursing schools, researchers and students in statistics, and anyone needing to assess the evidence published in medical journals." A review by Rebecca Rooney in the International Journal of Epidemiology states: "This book is a clear, concise, and interesting read and should prove to be a useful guide. The examples and case studies make it easy to understand difficult concepts and the jokes and stories make it fun. There are some salient points and hopefully the reader will be enthused about looking at the published research and be more confident about distinguishing between the good and the bad." More information about the book (supporting materials, answers to the exercises, and other updates) can be found on the web at http://www.childrensmercy.org/stats/evidence.asp.

Where can you find this handout?

This handout and the handouts that I use for all of my seminars and training classes are a compilation of individual web pages at www.childrensmercy.org/stats. I use the "Include Page" feature of Microsoft FrontPage to combine these into a single page. You can always find the most recent version of this compilation by going to the web address listed at the bottom of this page. Links for the handouts for other seminars and classes appear at www.childrensmercy.org/stats/training.asp.

Why don't I use PowerPoint?

I stopped using PowerPoint for my presentations in the mid 1990's. This was based on Edward Tufte's advice that presenting information in a paper handout is more effective than presenting the information on a projected screen. I found this to be excellent guidance. I enjoy talking when I don't have to wrestle with a laptop computer. I look at my audience more and interact with them better. I elaborate on this in greater detail at www.childrensmercy.org/stats/weblog2004/powerpoint.asp.