Search results - The History and Philosophy of Evidence-Based Health Care
1 Wellington Square
OX1 2JA. Map
|Dates||Mon 17 to Fri 21 Jun 2013|
|Application status||Applications being accepted|
|Course contact||If you have any questions about this course, please email firstname.lastname@example.org or telephone +44 (0)1865 286945.|
History of science without philosophy of science is blind … philosophy of science without history of science is empty – Norwood Russell Hanson.
Galen, Maimonides, Avicenna, Descartes, and Locke were all medically qualified philosophers. More recently, Peter Medawar and Archie Cochrane were strongly influenced by Karl Popper. Recent studies suggest combining History and Philosophy of Science on the one hand, and health care on the other creates synergies for the mutual benefit of all disciplines.
Together with world leaders in philosophy, history, and EBHC (speakers include Professor Mike Kelly and Professor Nancy Cartwright), you will investigate:
- why/when controlled studies replaced reasoning from basic sciences and ‘expertise’
- the history and philosophy of ‘placebos’ and blinding
- the application of average treatment effects when treating individuals
- the role of values in deciding among treatments choices
- whether Evidence-Based Healthcare has done more good than harm
- how and why evidence synthesis (‘systematic reviews) arose
- the role of the sociology of science in Evidence-Based Healthcare
"The course will help me to structure my thinking about the advantages and limitations of EBM and to answer the questions I have about the interaction between EBM and the structure of current western healthcare systems."
"Gave me a completely different perspective on EBM. Eg. Being more specific about asking questions, being careful about language and terminology, being aware that non-medical folks look at the issues differently than medical ones, examining how philosophy might fit into my particular work."
"The content of the program (a very specific program regarding the background of EBM and its interaction with current healthcare systems), just where I was looking for!The luxury of a group of excellent lecturers. It was really nice to be exposed to such an enormous degree of expertise and inspiring idea's about EBM and healthcare! And that during a whole weekThe diversity of participants (countries, backgrounds, idea's)."
DescriptionThe History and Philosophy of Evidence-Based Health Care Flyer
Why study the history and philosophy of Evidence-Based Health Care (EBHC)?
- Become a better health care professional.Medical students who study the humanities perform better than those who focus exclusively on the sciences(Lancet 1996 (347:55-6), J Med Humanities 2004(30:53)).
- Learn to think more critically. Critical thinking is a pillar of analytic philosophy. You will be encouraged to question EBHC rather than accept it because it has become widely accepted. Our speakers have included influential critics of EBHC such as Ross Upshur and this year includes Nancy Cartwright.
- Become a better historian of medicine. The tutors on the course include Professor Ulrich Tröhler, Sir Iain Chalmers and Dr Mike Clarke Turner who will provide accounts of how EBHC arose, so the course is an invaluable case study.
- Why choose this course if you are neither a health care practitioner nor a philosopher or historian?. The lay press bombards us with claims that diets will cure disease, that new medical technology promises to prolong life, and that environmental factors will lead to premature death. Because of the interdisciplinary nature of the course, technical jargon particular to each discipline will be either entirely avoided or explained. Hence the course is accessible to anyone interested in understanding the nature, history, and justification for the kinds of health claims they face on a daily basis.
- Become a better writer. History and Philosophy of Science involves writing critical essays. The course involves workshops on essay writing and an online peer review process to help you develop your ideas.
There will be plenary lectures by professors Nancy Cartwright and Mike Kelly.
- An introduction to the history and philosophy of EBHC
- The introduction of quantification in assessing treatment effects
- The introduction of systematic reviews (evidence synthesis)
- The introduction of measures to ensure that like will be compared with like in treatment comparisons
- The history of blinding/masking to reduce observer biases
- Examining critiques of the EBHC stance on ‘pathophysiologic rationale’
- The philosophy of blinding/masking those involved in testing treatments
- Examination of arguments that average results are of questionable relevance to individuals
- The history of probabilistic thinking and statistical analysis in testing treatments
- What role does the sociology of science play?
- What are the explicit (and hidden) ways in which values come into (or should come into) EBHC?
- Views from the wild: applying philosophy of EBHC in actual health care practice
Dr Jeremy Howick
Role: Module Coordinator
Dr Amanda Burls
Amanda Burls is a Senior Clinical Fellow.
Sir Iain Chalmers
Professor Mike Clarke
Professor Bill Fulford
Dr Carl Heneghan
Prof Mike Kelly
Professor Ulrich Tröhler
By the end of the course students will be able to:
- explain key philosophical concepts (‘epistemology’, ‘ontology’, ‘value theory’)
- defend and critique EBHC
- compare different historical approaches to understanding the origins of EBHC (quantification, the evolution of measures to reduce biases, statistical analysis of treatment tests)
- think critically
- write a philosophical or historical essay
Students who wish to take the course for credit will be expected to write an extended essay of no more than 4000 words to a standard suitable for submission to a peer-reviewed journal. In this, students will be expected to explore, in depth, one aspect of the history and/or philosophy of EBHC. Essay topics will be chosen from a list (see below). Tutors from the course will supervise this work, and students will also act as peer reviewers and editors. Together with their supervisors, students will be encouraged to submit their essays to peer-reviewed journals.
The content and assignment for the module will be at a level that would be sufficient for 20 Masters level CATs.
Possible essay topics
- Do evidence hierarchies have any useful purpose?
- Why is ‘pathophysiologic rationale’ not ranked highly in EBHC hierarchies?
- If ‘pathophysiologic rationale’ is undervalued as evidence for efficacy, can it play a role in generalizing the results of controlled studies, if so how?
- What is the role of clinical expertise in EBHC?
- What is the role of values in EBHC?
- If randomised trials provide ‘best’ evidence, why don’t we need them to show that stopping massive bleeding saves lives?
- Is CONSORT’s new policy on the importance of reporting the success of double blinding justified?
- Is it ethical to conduct systematic reviews of unethical studies?
- What are the historical roots of various aspects of EBHC methods?
- When did medical textbooks first start paying attention to ‘evidence’?
- How relevant is the year 1992 in the history of EBHC?
Level and demands
The main prerequisite for the course is enthusiasm for the subject. The course is designed to introduce students to the history and philosophy of EBHC and no background or education in history or philosophy will be required. Students will also generally be expected to have an undergraduate degree.
The main texts associated with this course are:
- Howick, J. (2011) The Philosophy of Evidence-Based Medicine: a philosophical inquiry. Blackwell-Wiley.
- Chalmers I. James Lind Library: explaining and illustrating the evolution of fair tests of treatments. www.jameslindlibrary.org
- Tröhler U (2000). ‘To improve the evidence of medicine’: the 18th century British origins of a critical approach. Edinburgh: Royal College of Physicians. Available for free download from http://tinyurl.com/9blkdjo.
- Wootton, D. (2006) Bad Medicine. Oxford, Oxford University Press.
- Fulford, KWM, Peile E., and Carrol, H. (forthcoming  Essential Values-Based Medicine: linking science with people. Cambridge, CUP.
The course will combine face-to-face teaching in Oxford and online distance learning. During the teaching week we will use a combination of short lectures, interactive seminars, group work and in-class activities. There will also be preparatory reading and online interaction before and after the course, with follow-up on extended essay preparation.
Teaching outcomesBy the end of the course students will
- be able to think more critically (decide what counts as an acceptable argument).
- successfully write an extended critical essay.
- be able to explain key ideas in philosophy, ‘epistemology’, ‘ontology’, ‘value theory’ the ‘rationalist/empiricist debate’, and ‘paradigm’.
- be able to defend and critique the EBM ‘hierarchy of evidence’ using philosophical principles’.
- be able to compare different historical approaches to the origins of EBHC (allocation, blinding, ‘placebo’ controls).
- be able to explain the role of values in EBHC.
Accommodation is available at the Rewley House Residential Centre, within the Department for Continuing Education, in central Oxford. The comfortable, en-suite, study-bedrooms are rated 3-star, and come with free high-speed internet access and TV. Guests can take advantage of the excellent dining facilities and common room bar, where they may relax and network with others on the programme.
Details of funding opportunities, including grants, bursaries, loans, scholarships and benefit information are available on our financial assistance page.
- Programme Fee
- Students enrolled on MSc in Evidence-Based Health Care: £1500.00
- Students enrolled on Postgraduate Dip in Health Research: £1500.00
- Short course in health sciences: £1890.00
Apply for this course
This course can be taken with academic credit (assignment of up to 4,000 words) or without academic credit, please indicate on your form which option you are applying for.
You can apply for this course in the following ways:
- Apply by post, email or fax
- Application form .
Terms and Conditions (important: please read before applying) .