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.

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.

Machine Evidence: Trial by AI

Take a look at the following snippets from descriptions of clinical trials, thinking about how you’d rate the quality and strength of the evidence that comes from each: 1: We conducted a clinical trial in which erythropoietin (EPO) administration was administered daily to patients with severe acne resulting in clinically significant …

Pluralism and the Problems of Demarcation

In 1983, Larry Laudan proclaimed the “Demise of the Demarcation Problem” (Laudan 1983). I will argue that the ‘simple demarcation’ problem should indeed be abandoned. However, abandoning the quest for simple demarcation does not entail that demarcation problems are intractable. Though the dream of a single criterion to demarcate ‘science’ …