The problem of evidence-based medicine: directions for social science.

摘要: Evidence-based medicine (EBM) is arguably the most important contemporary initiative committed to reshaping biomedical reason and practice. The move establish scientific research as a fundamental ground of medical decision making has met with an enthusiastic reception within academic medicine, but also generated considerable controversy. EBM broader forms evidence-based it occasioned raise provocative questions about relation knowledge social action across variety domains. Social science inquiry not yet reached scale one might expect, given breadth significance phenomenon. This paper contributes reflections, critique analysis aimed at helping build more robust investigation EBM. begins "diagnostics" existing literature on EBM, emphasizing possibilities limitations its two central organizing analytic perspectives: political economy humanism. We further explore emerging trends in including turn original empirical embrace "newer" theoretical resources such postmodern critique. argue for need beyond concerns rationalization potential erasure patient and, this end, suggest new avenues exploration. latter include clinical epidemiology discursive preconditions role site production evidence, textually mediated character