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.

The Machine Scientists: Iatrophysics and Selective Scientific Realism

The Machine Scientists – Giovanni Borelli, Jan Swammerdam and Niels Steensen – followed Rene Descartes in modelling the human body mechanically. The scientific success of this ‘iatrophysical’ programme, replete with rejected entities such as ‘Animal Spirits’, poses a problem for Scientific Realism. Using Psillos’ moderate realism, this paper attempts to reconcile a selective realist position with the historical record.

Imitating Imitation: a response to Floridi & Chiriatti

In their 2020 paper, Floridi and Chiriatti subject giant language model GPT-3 to three tests: mathematical, semantic and ethical. I show that these tests are misconfigured to prove the points Floridi and Chiriatti are trying to make. We should attend to how such giant language models function to understand both their responses to questions and the ethical and societal impacts.

Minding the Gaps: Statistical Misrepresentation in Attainment Gap Research

Political interests configure the stories we tell with data. Closing the gap in attainment between disadvantaged students and their advantaged contemporaries is pivotal to an agenda to use education as a positive social force. But both the measurement and representation of this gap is politicised, skewed and open to manipulation. This paper shows how two organisations with inverse aims represent—and misrepresent—their measure of the attainment gap to portray diametric trajectories in the pursuit of equal attainment.

Pathognomy, Sine Qua Non and Constitutive Matching (Philosophy of Diagnosis, Part 2)

This series of philosophical papers unpacks six philosophical issues in diagnostics and develops a pluralistic model of diagnosis. This paper presents a set of minimal constraints which any theory of diagnostics must satisfy based on pathognomy and sine qua non relationships.

The Dismal Disease: Temozolomide and the Interaction of Evidence

“I think the challenge is really that we still, not only in glioblastoma, but in oncology at large, treat the majority of patients with a one-size-fits-all approach.” — Roger Stupp    Blockbuster drugs are rare. To be a blockbuster, a drug must shift over $1bn worth in one year. There …

The Authority of Evidence-Based Medicine

In the early part of the 20th century, the philosopher Ludwig Wittgenstein sought to demonstrate that metaphysical claims are meaningless. Statements which couldn’t be proven true in some way—through logic or evidence—weren’t even false, they had no meaning at all. But he ran up against a problematic irony. His book, …

The Positivity Machine: “Evidence-Based Alternative Medicine” and Grades of Recommendation

By definition, I begin, Alternative Medicine, I continue, Has either not been proved to work, or been proved not to work. Do you know what they call alternative medicine that’s been proved to work? Medicine. —Tim Minchin, Storm   In his beat-poem Storm, the musician and comedian Tim Minchin lays …