How does a machine learning algorithm picture hierarchies of evidence and evidence-based medicine – and what do these visions of evidence remind us of the way we understand, order and assemble the information we use to guide clinical practice?
What was the first evidence pyramid? A deep dive into the murky history of this novel way to present an evidence hierarchy reveals a significantly earlier origin that previously presumed.
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.
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?
The Global Summit systematic review claims that spinal manipulation therapy is not effective in preventing any non-musculoskeletal disorders. But a breakaway group has challenged their findings, in part based on my arguments regarding evidence hierarchies. Are they correct? Does my critique undermine the Global Summit review? If so, does the evidence base favour chiropractic?
Pressure mounts upon equalities minister Kemi Badenoch to resign over the UK government’s failure to ban conversion therapies. Attention has focused on the government’s failure to publish research commissioned in 2018. But evidence about whether conversion therapy works is irrelevant: conversion therapy is not a medical intervention.
Do medical scientists need philosophers of medicine like birds need ornithologists? A quotation often attributed to Richard Feynman claims that “philosophy of science is as useful to scientists as ornithology is to birds”. Feynman, never the intellectual slouch, acutely discounts the value of philosophy of science to him, without actually claiming that philosophers are useless, valueless, …
The database of evidence hierarchies has been updated based on a new systematic review of the medical literature, and now contains over 195 hierarchies.
In the five years since the publication of Hierarchies of Evidence in Evidence-Based Medicine, what has changed and what lessons can philosophers learn?
Throughout my career as a philosopher of medicine, I have taken a special interest in hierarchies of evidence as used in Evidence-Based Medicine (EBM) and beyond. My critique of evidence hierarchies has adapted and developed alongside recent movements towards a less rigid hierarchalism in EBM, and with the development of …