Category: Evidence-Based Medicine

Evidence-Based Medicine, Hierarchies of Evidence, Philosophy of Medicine

The Pyramid Schema: The Origins and Impact of Evidence Pyramids

[This paper has been updated in 2026 from the 2022 preprint] Evidence pyramids are amongst the most recognisable artefacts of the Evidence-Based Medicine movement. Yet no study has established the origins of evidence pyramids, or analysed whether they offer any information beyond simple lists or tables. In this paper, I establish the origins of the first evidence pyramid and argue that the pyramidal turn is a retrograde step in evidence appraisal.

Evidence-Based Medicine, Hierarchies of Evidence, Philosophy of Medicine

[Superseded] The Pyramid Schema: The Origins and Impact of Evidence Pyramids

Evidence pyramids are amongst the most recognisable artefacts of the Evidence-Based Medicine movement. Yet no study has established the origins of evidence pyramids, or analysed whether they offer any information beyond simple lists or tables. In this paper, I establish the origins of the first evidence pyramid and argue that the pyramidal turn is a retrograde step in evidence appraisal.

Evidence-Based Medicine, Philosophy of Science, Temozolomide

Lumping and splitting: brain tumours in white Britons

A much-publicised report suggests that white Britons’ brain tumour survival rates are lower than other ethnicities. But analysing the ethnicities categories used, and considering the diversity of the “brain tumour” label, complicates the picture, as the ‘Dismal Disease’ of Glioblastoma continues to confound.

Artificial Intelligence, Hierarchies of Evidence

The Jurassic Critique of Micozzi on Evidence Hierarchies

AI21 Labs have just released a public demo of their giant language model, Jurassic-1. At 178bn parameters, it rivals GPT-3. Feeding it my own work, it generated some interesting and potentially novel views on evidence hierarchies… and then attributed them to CAM researcher Marc Micozzi! Is Jurassic Micozzi’s critique of evidential pluralism in medicine sound?