De Vries Raymond, Lemmens Trudo
University of Michigan, Ann Arbor, USA.
Soc Sci Med. 2006 Jun;62(11):2694-706. doi: 10.1016/j.socscimed.2005.11.026. Epub 2005 Dec 22.
Most critiques of evidence-based medicine (EBM) focus on the scientific shortcomings of the technique. Social scientists are more likely to criticize EBM for it ideological biases, a criticism that makes sociological sense but is difficult to substantiate. Using data from our studies of (1) the influence of pharmaceutical companies on the conduct and reporting of clinical trials, and (2) obstetric science in the Netherlands (where nearly one-third of births occur at home) we show how the evidence of evidence-based medicine is shaped by forces both structural and cultural. The threats to objective evidence are many, and, if EBM is to be true to its own principles, it must take these threats into account.
大多数对循证医学（EBM）的批评都集中在该技术的科学缺陷上。社会科学家更倾向于批评循证医学存在意识形态偏见，这种批评在社会学上有一定道理，但难以得到证实。利用我们对（1）制药公司对临床试验的开展和报告的影响，以及（2）荷兰的产科科学（近三分之一的分娩在家中进行）的研究数据，我们展示了循证医学的证据是如何受到结构和文化力量塑造的。对客观证据的威胁众多，如果循证医学要忠实于自身原则，就必须考虑到这些威胁。
