The concept of evidence-based evidence: Critical standard and standardized critique. an exploration of the EBM philosophy of science discussion within health care.

Project summary

Background:

Since the 1990’s, Evidence based practice (EBP) has been a central concept within a growing range of fields, especially within health care. The main attraction of the concept of EBP seems to be that it enables identification of an effective treatment in a reliable way, by using clear and concise criteria. However, the confidence in and the use of EBP is a highly controversial matter; EBP has been the target of incessant critique, not at least by different kinds of philosophy of science. The main focus will be analysis and discussion of the critique of EBP, and of the ways the critique is set forth by central views in philosophy of science (hereby: the EBP philosophy of science)

While parts of the critique set forth by philosophy of science focusses on nuanced points, other parts tends to be less sensitive, creating an image of EBP as a narrow minded and positivistic movement. Such an image is unnecessarily over-simplified and superficial, leading to neither constructive debate nor better understanding of the subject.

Further, there is a tendency that the critique is too narrow and one-way tracked. Firstly, many of the critical arguments are rather similar to each other, so that the quantity in numbers not necessarily represents a differentiated critique. Secondly, the existing critique of EBP is seldom met with an adequate response by the users of EBP. The Ph.D.-project/WP4 will examine the reasons for these problems.

Today, there exists no study which presents a systematic overview of the critique set forth by the EBP philosophy of science. The current project will focus on the content and implications of this critique.

Aim:

The aim of this study is to investigate the content and implications of the critique of the EBP philosophy of science. Hereby, the study will 1) examine how the critique operates with different understandings of the concept of EBP, and 2) differentiate between different kinds of critique, regarding both different positions within the philosophy of science and differences between the Norwegian and the international critique.

Questions: The following questions will be addressed:

1. In what ways are the concept of EBP understood and used in educational and theoretical literature within the field of health care?
2. What are the central and typical content of the critique, within the international EBP philosophy of science?
3. What are the central and typical content of the critique, within the Norwegian EBP philosophy of science?

These questions will lead to a discussion of two central themes:

1. Which parts of the critique set forth by the EBP philosophy of science is relevant and constructive?
2. Is it possible to find a better, more constructive basis for the critique regarding EBP philosophy of science?

Method

The questions will be addressed by critical examinations of central definitions and readings of theoretical discussions of the concept of EBM, set forth both by health care scientists and practitioners as well as by central literature on EBP philosophy of science.