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接受语境如何影响 RCT 证据的意义。

How the context of reception affects the meaning of RCT evidence.

机构信息

University of Essex, UK.

出版信息

Health (London). 2024 Mar;28(2):253-271. doi: 10.1177/13634593221134011. Epub 2022 Nov 5.

Abstract

This article takes as a case study a set of disagreements in the early 2000s about randomised controlled trial (RCT) evidence for a newly developed drug in the field of intensive care medicine. The interpretation of RCT findings - and in particular, the application of these findings to clinical practice - were contested among research-active intensive care doctors, despite their shared professional and epistemic values. I examine the arguments about scientific interpretation and application to clinical practice advanced by two readily identifiable groups. The analysis documents how four particular aspects of scientific knowledge were perceived and portrayed differently by the two groups, and notes how each group was associated with different kinds of routine work practices and external networks. My argument is that these differences give rise to distinctive hermeneutic frames and orientations towards the scientific results and disparities in their consequential judgements regarding the legitimate use of the newly developed drug, and I extend Stones and Turner's concept to make the link between context and hermeneutic frames and orientations. The analysis has implications for furthering our understanding of how the clinical meaning attributed to scientific evidence is affected by the context of reception of results, even where epistemic and professional values are shared.

摘要

本文以 21 世纪初 intensive care medicine 领域一种新开发药物的随机对照试验(RCT)证据的分歧为例。尽管研究型 intensive care 医生具有共同的专业和认识论价值观,但他们对 RCT 结果的解释——特别是将这些发现应用于临床实践——存在争议。我考察了两个易于识别的群体提出的关于科学解释和应用于临床实践的论点。分析记录了两组对科学知识的四个特定方面的不同看法和描述,并指出了每个群体与不同类型的常规工作实践和外部网络的关联。我的论点是,这些差异导致了对科学结果的不同解释框架和取向,以及对新开发药物的合法使用的后果判断存在差异,我扩展了 Stones 和 Turner 的概念,将语境和解释框架与取向联系起来。该分析对于进一步理解即使在共享认识论和专业价值观的情况下,结果的接受背景如何影响归因于科学证据的临床意义具有重要意义。

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