Ashcroft R E
Imperial College London, Department of Primary Health Care and General Practice, London, UK.
J Med Ethics. 2004 Apr;30(2):131-5. doi: 10.1136/jme.2003.007039.
Evidence based medicine has been a topic of considerable controversy in medical and health care circles over its short lifetime, because of the claims made by its exponents about the criteria used to assess the evidence for or against the effectiveness of medical interventions. The central epistemological debates underpinning the debates about evidence based medicine are reviewed by this paper, and some areas are suggested where further work remains to be done. In particular, further work is needed on the theory of evidence and inference; causation and correlation; clinical judgment and collective knowledge; the structure of medical theory; and the nature of clinical effectiveness.
在其短暂的发展历程中，循证医学一直是医疗卫生领域颇具争议的话题，原因在于其倡导者对用于评估支持或反对医学干预有效性证据的标准所提出的主张。本文回顾了支撑循证医学辩论的核心认识论辩论，并指出了一些仍有待进一步开展工作的领域。特别是，在证据与推理理论、因果关系与相关性、临床判断与集体知识、医学理论结构以及临床有效性的本质等方面，仍需开展进一步的工作。
