ReviewJournal of medical ethics2004
Evidence based medicine guidelines: a solution to rationing or politics disguised as science?
Review in Journal of medical ethics, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care.Journal of general internal medicine · 2018Pooled it
- From "getting things right" to "getting things right now": Developing COVID-19 guidance under time pressure and knowledge uncertainty.Journal of evaluation in clinical practice · 2022Article
- The Ethic of Responsibility: Max Weber's Verstehen and Shared Decision-Making in Patient-Centred Care.The Journal of medical humanities · 2021Article
- Can clinical ethics committees be legitimate actors in bedside rationing?BMC medical ethics · 2019Article
- Moral entrepreneurship, the power-knowledge nexus, and the Cochrane "crisis".Journal of evaluation in clinical practice · 2019Article
- Development and validation of the Evidence Based Medicine Questionnaire (EBMQ) to assess doctors' knowledge, practice and barriers regarding the implementation of evidence-based medicine in primary care.BMC family practice · 2018Article
- Burden of Disease Study and Priority Setting in Korea: an Ethical Perspective.Journal of Korean medical science · 2016Review
- Simplistic and complex thought in medicine: the rationale for a person-centered care model as a medical revolution.Patient preference and adherence · 2016Article
- Recentralizing healthcare through evidence-based guidelines - striving for national equity in Sweden.BMC health services research · 2014Article
- Sample size matters: A guide for urologists.Indian journal of urology : IJU : journal of the Urological Society of India · 2011Article
- Evidence-based surgery--evidence from survey and citation analysis in orthopaedic surgery.Annals of the Royal College of Surgeons of England · 2011Article
- Priority setting in primary health care - dilemmas and opportunities: a focus group study.BMC family practice · 2010Article
- Balancing health care evidence and art to meet clinical needs: policymakers' perspectives.Journal of evaluation in clinical practice · 2009Article
- A knowledge synthesis of patient and public involvement in clinical practice guidelines: study protocol.Implementation science : IS · 2009Article
- Ethical analysis to improve decision-making on health technologies.Bulletin of the World Health Organization · 2008Article
- Access to high cost medicines in Australia: ethical perspectives.Australia and New Zealand health policy · 2008Article
- Evidence-based medicine - perspectives of a community-based paediatrician.Paediatrics & child health · 2007Article
- Shared decision-making based on different features of risk in the context of diabetes mellitus and rheumatoid arthritis.Therapeutics and clinical risk management · 2007Article
- Recognizing tacit knowledge in medical epistemology.Theoretical medicine and bioethics · 2006Article
- Radiography and Clinical Decision-Making in Chiropractic.Dose-response : a publication of International Hormesis SocietyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
"Evidence based medicine" (EBM) is often seen as a scientific tool for quality improvement, even though its application requires the combination of scientific facts with value judgments and the costing of different treatments. How this is done depends on whether we approach the problem from the perspective of individual patients, doctors, or public health administrators. Evidence based medicine exerts a fundamental influence on certain key aspects of medical professionalism. Since, when clinical practice guidelines are created, costs affect the content of EBM, EBM inevitably becomes a form of rationing and adopts a public health point of view. This challenges traditional professionalism in much the same way as managed care has done in the US. Here we chart some of these major philosophical issues and show why simple solutions cannot be found. The profession needs to pay more attention to different uses of EBM in order to preserve the good aspects of professionalism.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.