The History and Philosophy of Evidence-Based Health Care

Course summary

  • Mon 27 Mar 2017 to Fri 31 Mar 2017
  • Rewley House, 1 Wellington Square, Oxford, Oxfordshire, OX1 2JA.
  • From £1740.00
  • 20 CATS points
  • Course code O16C208B9Y
  • cpdhealth@conted.ox.ac.uk
  • +44 (0)1865 286941
  • Applications being accepted

The History and Philosophy of Evidence-Based Health Care



Overview

Why and how did evidence-based medicine arise, and why should you accept it?

The module will trace the historical development of evidence-based health care. Students on this course will engage with researchers who have played key roles in defining the History, Philosophy and actual practice of Evidence-Based Healthcare. Many famous medical doctors, including Galen, Descartes and Locke, were also philosophers, and recent evidence suggests that studying humanities improves clinical skills. Medical professionals will learn to think critically about the assumptions of their profession while philosophers and historians will learn about the empirical foundations of the science they contemplate. Many past students have published their assignments for the course in peer-reviewed journals.

Lecturers on the course include:

Dr Jeremy Howick (University of Oxford)

Professor Alexander Bird (University of Bristol)

Professor Mike Clarke (Queen's University Belfast)

Professor Brian Hurwitz (King's College London)

Ms Sarah Wieten (University of Durham)

Dr Andrew Papanikitas (University of Oxford)

Mr Alexander Mebius (University of Oxford)

The last date for receipt of complete applications is 5pm Friday 10th March 2017. Regrettably, late applications cannot be accepted.

 

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, Professor Nancy Cartwright, Dr Amanda Burls and Professor Rom Harre.
  • Become a better historian of medicine. The tutors on the course include Dr. Jeremy Howick, Professor Mike Clarke and Professor Brian Hurwitz 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. It is important for all of us to be able to critically evaluate these claims. 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. Many students have published their essays in peer reviewed journals.

There are will also be plenary sessions led by leading experts within the field of EBHC.

Core Reading

 

  • Howick J (2011). The Philosophy of Evidence-Based Medicine: a philosophical inquiry. Blackwell-Wiley. Chapters 1-3
  • 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.

The following is also recommended as part of this module.

  • Wootton, D. (2006) Bad Medicine. Oxford, Oxford University Press.
  • Fulford, KWM, Peile E., and Carrol, H. (forthcoming [2011] Essential Values-Based Medicine: linking science with people. Cambridge, CUP.

 

Comments from previous participants:

"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)."

Programme details

Session topics

  • What is the philosophy of EBHC?
  • What is the evidence that EBHC has done more good than harm?
  • 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

Accommodation

Accommodation is available at the Rewley House Residential Centre, within the Department for Continuing Education, in central Oxford. The comfortable, en-suite, study-bedrooms have been rated as 4-Star Campus accommodation under the Quality In Tourism scheme, and come with tea- and coffee-making facilities, free Wi-Fi access and Freeview 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.

IT requirements

Please ensure that you have access to a computer that meets the specifications detailed on our technical support page.

Fees

Short Course in Health Sciences: £2110.00
Students enrolled on MSc in Evidence-Based Health Care: £1740.00
Students enrolled on Postgraduate Dip in Health Research: £1740.00

Funding

Details of funding opportunities, including grants, bursaries, loans, scholarships and benefit information are available on our financial assistance page.

Tutors

Dr Jeremy Howick

Module Coordinator

Jeremy Howick is a Senior Researcher, Nuffield Department of Primary Care Health Sciences and the NSPCR Non-Clinical Research Fellow.

Course aims

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

Teaching methods

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 outcomes

By 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.

Assessment methods

Academic Credit

Those wishing to take the course for credit. The University of Oxford Department for Continuing Education offers Credit Accumulation and Transfer Scheme (CATS) points for the course. Participants attending at least 80% of the taught course and successfully completing assessed assignments are eligible to earn credit equivalent to 20 CATS-equivalent points which may be counted towards a postgraduate qualification.

Attendance Only

This includes:

  • attendance at five full days of teaching by world renowned experts in evidence-based health care at the University of Oxford.
  • access to a dedicated online virtual learning environment prior to and during the five taught days
  • access to pre-course reading materials

Applicants registering as "Attendance Only" are not eligible to undertake the academic assignment offered to students on award-bearing programmes of study and will not have access to the University library resources, other than those provided by the Department for Continuing Education. Applicants cannot receive CAT (Credit Accumulation and Transfer Scheme) points or equivalence. Credit cannot be attributed retrospectively. CAT accreditation is required if you wish for the module to count towards a further qualification in the future.

A Certificate of Completion is issued at the end of the course.

“Attendance Only" applicants who subsequently wish to register for academic credit and complete the assignment are required to submit additional information, which must be received 1 calendar month in advance of the module start date. Please contact us for more information.

Please contact cpdhealth@conted.ox.ac.uk if you have any questions.

Possible essay topics

  1. Do evidence hierarchies have any useful purpose?
  2. Why is ‘pathophysiologic rationale’ not ranked highly in EBHC hierarchies?
  3. If ‘pathophysiologic rationale’ is undervalued as evidence for efficacy, can it play a role in generalizing the results of controlled studies, if so how?
  4. What is the role of clinical expertise in EBHC?
  5. What is the role of values in EBHC?
  6. If randomised trials provide ‘best’ evidence, why don’t we need them to show that stopping massive bleeding saves lives?
  7. Is CONSORT’s new policy on the importance of reporting the success of double blinding justified?
  8. Is it ethical to conduct systematic reviews of unethical studies?
  9. What are the historical roots of various aspects of EBHC methods?
  10. When did medical textbooks first start paying attention to ‘evidence’?
  11. How relevant is the year 1992 in the history of EBHC?

Application

We strongly recommend that you download and save files before completing to ensure that all your changes are saved.

This course requires you to complete the application form and submit along with a copy of your CV. If you are applying to take this course for academic credit you will also need to complete section two of the reference form and forward it to your referee for completion. Please note that if you are not applying to take the course for academic credit then you do not need to submit a reference.

Please ensure you read the guidance notes before completing the application form, as any errors resulting from failure to do so may delay your application.

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.

Selection criteria

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.

Admissions Criteria:
To apply for the course you should:

 

  • be a graduate or have successfully completed a professional training course
  • demonstrate an interest in the history or philosophy of evidence-based healthcare, either through graduate study or professional work
  • be able to combine intensive classroom learning with the application of the principles and practices of evidence-based health care within the work place
  • have a good working knowledge of email, internet, word processing and Windows applications (for communications with course members, course team and administration)
  • show evidence of the ability to commit time to study and an employer's commitment to make time available to study, complete course work and attend course and university events and modules.

If you have any questions about your eligibility, please contact Jeremy Howick, module coordinator, directly on Jeremy.howick@phc.ox.ac.uk