Department of Philosophy and Religious Studies, Old Dominion University, Norfolk, VA 23529, USA.
J Eval Clin Pract. 2013 Jun;19(3):422-6. doi: 10.1111/jep.12035.
In evidence-based medicine's hierarchy of evidence, physiological research ranks very low. Recent work in philosophy of science has suggested that there may be a role for knowledge of physiological mechanisms in clinical decision making, either (in some rare circumstances) by providing sufficient evidence that a therapy is effective or by bridging the gap between the results of clinical research and the care of individual patients. I argue that both suggestions are problematic and suggest an alternative role for physiological research. Specifically, I suggest that knowledge of physiological mechanisms should be better incorporated into the kind of epidemiological research that is central to evidence-based medicine.
在循证医学的证据层级中，生理学研究的层级非常低。最近科学哲学领域的工作表明，生理学机制的知识可能在临床决策中发挥作用，要么（在某些罕见情况下）通过提供充分的证据表明一种疗法是有效的，要么通过弥合临床研究结果与个体患者护理之间的差距。我认为这两种建议都存在问题，并提出了生理学研究的另一种作用。具体来说，我建议将生理学机制的知识更好地纳入到循证医学的核心——流行病学研究中。
