ArticleTheoretical medicine and bioethics2013
Problems with using mechanisms to solve the problem of extrapolation.
Article in Theoretical medicine and bioethics, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
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- Causal Pluralism in Medicine and its Implications for Clinical Practice.Journal for general philosophy of science = Zeitschrift fur allgemeine Wissenschaftstheorie · 2024Article
- Assessing the credibility of a drug's effects: identification and judgment of uncertainty by the Dutch Medicines Evaluation Board.Frontiers in medicine · 2024Article
- Evidence-based Medicine and Mechanistic Evidence: The Case of the Failed Rollout of Efavirenz in Zimbabwe.The Journal of medicine and philosophy · 2023Article
- Redox regulation of immunity and the role of small molecular weight thiols.Redox biology · 2021Article
- Mechanisms in clinical practice: use and justification.Medicine, health care, and philosophy · 2020Article
- Evidence for personalised medicine: mechanisms, correlation, and new kinds of black box.Theoretical medicine and bioethics · 2019Article
- Is it possible to overcome issues of external validity in preclinical animal research? Why most animal models are bound to fail.Journal of translational medicine · 2018Review
- Understanding and misunderstanding randomized controlled trials.Social science & medicine (1982) · 2018Article
- Conceptualizing the transfer of knowledge across cases in transdisciplinary research.Sustainability science · 2018Article
- Benefit Transfer Challenges: Perspectives from U.S. Practitioners.Environmental & resource economics · 2018Article
- Evaluating the UK House of Commons Science and Technology Committee's position on the implausible effectiveness of homeopathic treatments.Theoretical medicine and bioethics · 2017Article
- The oxidative stress theory of disease: levels of evidence and epistemological aspects.British journal of pharmacology · 2017Review
- Intervention Component Analysis (ICA): a pragmatic approach for identifying the critical features of complex interventions.Systematic reviews · 2015Review
- Can animal data translate to innovations necessary for a new era of patient-centred and individualised healthcare? Bias in preclinical animal research.BMC medical ethics · 2015Article
- Revolution and progress in medicine.Theoretical medicine and bioethics · 2015Article
- Interdisciplinary workshop in the philosophy of medicine: medical knowledge, medical duties.Journal of evaluation in clinical practice · 2014Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Proponents of evidence-based medicine and some philosophers of science seem to agree that knowledge of mechanisms can help solve the problem of applying results of controlled studies to target populations ('the problem of extrapolation'). We describe the problem of extrapolation, characterize mechanisms, and outline how mechanistic knowledge might be used to solve the problem. Our main thesis is that there are four often overlooked problems with using mechanistic knowledge to solve the problem of extrapolation. First, our understanding of mechanisms is often (and arguably, likely to remain) incomplete. Secondly, knowledge of mechanisms is not always applicable outside the tightly controlled laboratory conditions in which it is gained. Thirdly, mechanisms can behave paradoxically. Fourthly, as Daniel Steel points out, using mechanistic knowledge faces the problem of the 'extrapolator's circle'. At the same time, when the problems with mechanistic knowledge have been addressed, such knowledge can and should be used to mitigate (nothing can entirely solve) the problem of extrapolation.
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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.