Paul Elisabeth, Brown Garrett W, Ridde Valéry, Sturmberg Joachim P
Université Libre de Bruxelles, School of Public Health, Campus Erasme, Route de Lennik 808, CP 591, 1070, Brussels, Belgium.
University of Leeds, School of Politics and International Studies (POLIS), Leeds, United Kingdom.
Public Health Pract (Oxf). 2024 Mar 29;7:100493. doi: 10.1016/j.puhip.2024.100493. eCollection 2024 Jun.
"Anti-science" accusations are common in medicine and public health, sometimes to discredit scientists who hold opposing views. However, there is no such thing as "one science". Epistemology recognizes that any "science" is sociologically embedded, and therefore contextual and intersubjective. In this paper, we reflect on how "science" needs to adopt various perspectives to give a comprehensive and nuanced understanding of a phenomenon.
Opinion paper.
Based on a targeted literature survey, we first clarify the known limits of traditional scientific methods and then reflect on how the scientific reporting about Covid-19 mRNA vaccines has evolved.
The first reports of the Covid-19 mRNA vaccines randomised controlled trial results showed impressive efficacy. Nevertheless, an abundant literature has since depicted a far more nuanced picture of the effectiveness and safety of those vaccines over the medium-term. We organise them around five themes: (i) differentiating between relative and absolute reduction; (ii) taking account of time in reporting effectiveness; (iii) taking account of all outcomes, including adverse effects; (iv) stratifying effectiveness and considering other decision criteria (efficiency, equity, and acceptance); (v) changing the outcome of concern and assessing vaccines' effectiveness on mortality.
Science offers a wide range of perspectives on a given study object. Only the process of deliberation amongst scientists and other stakeholders can result in accepted new knowledge useful to support decision-making. Unfortunately, by trying to reduce "science" to simple messages set in stone, scientists can become the worse enemies of science.
“反科学”的指责在医学和公共卫生领域屡见不鲜,有时是为了诋毁持有不同观点的科学家。然而,并不存在“单一科学”这样的东西。认识论认为,任何“科学”在社会学意义上都是有其背景的,因此是情境化且基于主体间性的。在本文中,我们思考“科学”如何需要采用各种视角,以便对一种现象有全面而细致入微的理解。
观点论文。
基于有针对性的文献调查,我们首先阐明传统科学方法已知的局限性,然后思考关于新冠病毒信使核糖核酸疫苗的科学报道是如何演变的。
关于新冠病毒信使核糖核酸疫苗随机对照试验结果的首批报道显示出令人印象深刻的有效性。然而,自那以后,大量文献描绘了这些疫苗在中期有效性和安全性方面更为细致入微的情况。我们围绕五个主题对它们进行了整理:(i)区分相对降低率和绝对降低率;(ii)在报告有效性时考虑时间因素;(iii)考虑所有结果,包括不良反应;(iv)对有效性进行分层并考虑其他决策标准(效率、公平性和可接受性);(v)改变关注的结果并评估疫苗对死亡率的有效性。
科学为给定的研究对象提供了广泛的视角。只有科学家和其他利益相关者之间的审议过程才能产生被认可的新知识,从而有助于支持决策。不幸的是,试图将“科学”简化为一成不变的简单信息,科学家可能会成为科学最糟糕的敌人。