Abstract：
:In modern philosophy, the concept of truth has been problematized from different angles, yet in evidence-based health care (EBHC), it continues to operate hidden and almost undisputed through the linked concept of "bias." To prevent unwarranted relativism and make better inferences in clinical practice, clinicians may benefit from a closer analysis of existing assumptions about truth, validity, and reality. In this paper, we give a brief overview of several important theories of truth, notably the ideal limit theorem (which assumes an ultimate and absolute truth towards which scientific inquiry progresses), the dominant way truth is conceptualized in the discourse and practice of EBHC. We draw on Belgian philosopher Isabelle Stengers' work to demonstrate that bias means one thing if one assumes a world of hard facts "out there," waiting to be collected. It means something different if one takes a critical view of the knowledge-power complex in research trials. Bias appears to have both an unproductive aspect and a productive aspect as argued by Stengers and others: Facts are not absolute but result from an interest, or interesse: a bias towards a certain line of questioning that cannot be eliminated. The duality that Stengers' view invokes draws attention to and challenges the assumptions underlying the ideal limit theory of truth in several ways. Most importantly, it casts doubt on the ideal limit theory as it applies to the single case scenario of the clinical encounter, the cornerstone of EBHC. To the extent that the goal of EBHC is to support inferencing in the clinical encounter, then the ideal limit as the sole concept of truth appears to be conceptually insufficient. We contend that EBHC could usefully incorporate a more pluralist understanding of truth and bias and provide an example how this would work out in a clinical scenario.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Wieringa S,Engebretsen E,Heggen K,Greenhalgh Tdoi
10.1111/jep.13010subject
Has Abstractpub_date
2018-10-01 00:00:00pages
930-938issue
5eissn
1356-1294issn
1365-2753journal_volume
24pub_type
杂志文章abstract：RATIONALE, AIMS AND OBJECTIVES:To evaluate adherence to guidelines for prophylactic antibiotic use in total knee replacement (TKR) and total hip replacement (THR) procedures and to examine the associations between guideline adherence and health care outcomes. METHODS:Using nationwide health insurance claims data, all ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2009.01182.x
更新日期：2009-12-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:In the UK fewer than 15% of familial hypercholesterolemia (FH) cases are diagnosed, representing a major gap in coronary heart disease prevention. We wished to support primary care doctors within the Medway Clinical Commissioning Group (CCG) to implement NICE guidance (CG71) and consider ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12481
更新日期：2016-06-01 00:00:00
abstract：OBJECTIVES:The purpose of this study is to examine Electronic Health Record (EHR) adoption among Florida doctors who treat the elderly. This analysis contributes to the EHR adoption literature by determining if doctors who disproportionately treat the elderly differ from their counterparts with respect to the utilizati...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2009.01277.x
更新日期：2010-12-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Second-generation antipsychotic agents have varying propensities to cause weight gain, elevated lipid levels and associated long-term complications. This study evaluates the cost-effectiveness of four second-generation antipsychotic agents used in Canada for the treatment of schizophrenia...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2009.01189.x
更新日期：2010-08-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:The aim of this study was to examine the validity of the Health of the Nation Outcome Scales (HoNOS) in terms of change in relation to sex, clinical characteristics and level of clinical change as assessed using other measures. METHODS:The sample consisted of N = 690 admissions from one ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12296
更新日期：2015-04-01 00:00:00
abstract：RATIONALE, AIMS, AND OBJECTIVES:Clinical practice guidelines (CPGs) are significant tools for evidence-based health care quality improvement. The CPG program at King Saud University was launched as a quality improvement program to fulfil the international accreditation standards. This program was a collaboration betwee...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12927
更新日期：2019-08-01 00:00:00
abstract：:The final years of life present challenges for care. In middle-/high-income countries, the percentage of people of advanced age in the population is growing, and the dying process continues to become more complex and protracted. We propose that a new understanding of care, 'teleological care', be considered as an impo...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,评审
doi：10.1111/jep.12211
更新日期：2014-12-01 00:00:00
abstract：:A previous study (Stanhope et al. 1998) established that staff in two obstetric units reported less than a quarter of designated incidents to the units' risk managers. A questionnaire was administered to 42 obstetricians and 156 midwives at the same two obstetric units, exploring the reasons for low rates of reporting...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1046/j.1365-2753.1999.00147.x
更新日期：1999-02-01 00:00:00
abstract：AIMS AND OBJECTIVE:To identify factors important in determining whether an obese child achieves significant reductions in Body Mass Index Standard Deviation Score (BMI SDS) within a UK, hospital-based paediatric obesity service aimed at lifestyle modification. DESIGN:Observational Study. SUBJECTS:137 obese children (...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2006.00706.x
更新日期：2007-06-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:It is suspected that childhood urinary tract infection (UTI) remains under-diagnosed in primary care, and is consequently the cause of subsequent morbidity from renal scarring, hypertension and eventual renal failure. Practice-based education and service developments were undertaken to tr...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1365-2753.2004.00507.x
更新日期：2005-02-01 00:00:00
abstract：OBJECTIVE:The main purpose of our study was to subjectively assess the quality of a paediatric intensive care unit (PICU) database according to the Directory of Clinical Databases (DoCDat) criteria. DESIGN AND SETTING:A survey was conducted between April 1 and June 15, 2018, among the Sainte Justine PICU research grou...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13193
更新日期：2020-02-01 00:00:00
abstract：RATIONALE, AIMS, AND OBJECTIVES:Ward rounds present opportunities for medical officers, nurses, allied health clinicians, and patients to interact and plan patient care. A recent literature review found eight types of rounding processes. Different purposes, varying levels of representation from clinical professions, an...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13248
更新日期：2020-06-01 00:00:00
abstract：BACKGROUND:Metaphors are central to the human understanding of complex issues; through the immediate associations they evoke and frame problems and suggest solutions. Our suggestion of Music in the Park as a metaphor for health systems reform brings to the forefront the environmentally diverse but bounded spaces of hea...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2010.01460.x
更新日期：2010-06-01 00:00:00
abstract：OBJECTIVES:Medication non-adherence is a major contributor to poor outcomes following discharge from psychiatric hospitals. It is therefore imperative that staff are able to accurately assess the extent to which patients have engaged with treatment. This study presents data on a new observer rating instrument of patien...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2008.00989.x
更新日期：2009-04-01 00:00:00
abstract：RATIONALE, AIMS, AND OBJECTIVES:Drug-related morbidity is common, which results in suffering for the patients and a high cost to society. SÄKLÄK2 is a multi-professional intervention model aiming at improving drug safety in primary health care. The objective of this study was to elucidate the perceptions of the partici...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13195
更新日期：2020-02-01 00:00:00
abstract：:According to Sackett, evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. In this article, clinical reasoning is depicted as multilayered processes of evidence construction by means of social interaction and hum...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1046/j.1365-2753.2002.00353.x
更新日期：2002-05-01 00:00:00
abstract：:Recent years have witnessed the rising star of evidence-based medicine (EBM) as an approach towards rationalizing clinical practice in the face of an exponentially growing body of knowledge. Along with it, however, a sense of unease is rising among practising doctors, as they feel that well-intentioned principles may ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2003.00473.x
更新日期：2004-05-01 00:00:00
abstract：:The paper proposes that frameworks typical to metaphysics and art could be used in clinical treatment in somatic and psychiatric contexts to ensure improved care. The concept of the "body electric" of somatic patients which I introduced in previous work is developed further and paired with the "mind electric" of psych...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12964
更新日期：2018-10-01 00:00:00
abstract：OBJECTIVE:To study which tests general practitioners used to diagnose a urinary tract infection (UTI) in children and which patient characteristics were associated with test choice. DESIGN:Retrospective chart review on the diagnosis of UTIs in children in Dutch general practices who were diagnosed as having a UTI. A t...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2008.01037.x
更新日期：2009-06-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to examine the impact of the use of an inter-professional care team on patient length of stay and payer charges in a geriatric transitional care unit. METHODS:An analysis of de-identified administrative records for transitional care patients for the 12-month period (2003-2004) care...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2008.01114.x
更新日期：2010-02-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:It has been proposed that delivery should be accomplished within 30 minutes after diagnosis of fetal distress. The objective of this study was to determine the decision-to-delivery interval (DDI) in emergency caesarean delivery for non-reassuring fetal heart rate (FHR). METHODS:A total o...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12613
更新日期：2016-12-01 00:00:00
abstract：RATIONALE, AIMS, AND OBJECTIVES:Current meta-analysis was conducted aiming to assess the efficacy and safety of recombinant human interleukin-11 (rhIL-11) in the treatment of acute leukaemia (AL) patients with chemotherapy-induced thrombocytopenia (CIT). METHODS:We searched PubMed, Embase, Chinese National Knowledge I...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13152
更新日期：2020-02-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Patients can play an important role in reducing health care harm. Finding strategies to encourage patients to take on an active role in issues related to the quality and safety of their care is therefore essential. The aim of this study was to examine patients' and health care professiona...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2011.01688.x
更新日期：2012-08-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Issues of overuse, underuse and misuse are paramount and lead to avoidable morbidity and mortality. Although evidence-based practice is advocated, the widespread implementation of this kind of practice remains a challenge. This is also the case for evidence-based practice related to the p...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2008.01019.x
更新日期：2009-04-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:To evaluate asthma management and control in primary care clinics so as to design improvements based on guideline-directed outcomes. METHODS:In this study, all medical records of asthma-diagnosed patients (children as well as adults, entire lifespan, asthma-related visits or not) were re...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2011.01803.x
更新日期：2013-04-01 00:00:00
abstract：:The Central Research and Development Committee is seeking to involve lay perspectives in the NHS R&D Programme. This paper describes some recent examples of lay involvement in each step of the research process from setting the agenda to making use of research findings. Innovative approaches have involved lay people in...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.1996.tb00057.x
更新日期：1996-11-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:This study aimed to apply the 'systems approach' to patient safety in order to identify causes for delays and errors in lung cancer diagnoses following an abnormal chest radiograph. METHODS:In the first part of this study, the systems approach to patient safety was comprehensively review...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12178
更新日期：2014-08-01 00:00:00
abstract：:Strand and Parkkinen criticize our dispositional account of causation in evidence-based medicine for failing to provide a proper epistemology of causal knowledge. In particular, they claim that we do not explain how causal inferences should be drawn. In response, we point out that dispositionalism does indeed have an ...
journal_title：Journal of evaluation in clinical practice
pub_type： 评论,杂志文章
doi：10.1111/jep.12189
更新日期：2014-12-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Hospital discharge notes can be used to identify rates of revisions in hip and knee arthroplasty surgeries if such administrative codes are accurate. In order to trust the data taken from the hospital discharge abstracts it is important to assess their reliability. The purpose of this stu...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1365-2753.2010.01622.x
更新日期：2012-06-01 00:00:00
abstract：OBJECTIVE:The purpose of the current study was to assess, in patients scheduled for primary total knee replacement (TKR), the effects of pre-surgery waiting time on pain and functional limitations related to the knee joint undergoing surgery, on health-related quality of life (HRQoL) and on contralateral knee pain 6 mo...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2010.01541.x
更新日期：2012-02-01 00:00:00
