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.
Would you choose a black box AI surgeon with a 90% success rate over a human surgeon with 80% success? The answer exposes a fundamental and harmful assumption within dominant models of medical evidence.
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.
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.
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 …
In 1972, Archie Cochrane published Effectiveness and Efficiency: Random Reflections on Health Services. In a little under 86 pages, Cochrane offers a wide-ranged but succinct delivery of his experience and his philosophy of evidence in clinical practice. It’s a fascinating gallop through the concerns of one of the most influential figures …