9. Transition to Part III

  1. Jeremy Howick1,2

Published Online: 23 MAR 2011

DOI: 10.1002/9781444342673.ch9

The Philosophy of Evidence-Based Medicine

The Philosophy of Evidence-Based Medicine

How to Cite

Howick, J. (2011) Transition to Part III, in The Philosophy of Evidence-Based Medicine, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444342673.ch9

Author Information

  1. 1

    Centre for Evidence-Based Medicine, Department of Public Health and Primary Care, University of Oxford, Oxford, UK

  2. 2

    Department of Science and Technology Studies, University College London, London, UK

Publication History

  1. Published Online: 23 MAR 2011
  2. Published Print: 8 APR 2011

ISBN Information

Print ISBN: 9781405196673

Online ISBN: 9781444342673



  • examining paradox that traditional roles for mechanistic reasoning - and expert judgment have been up-ended by EBM;
  • transition to Part III;
  • randomized trials, ruling out self-selection bias and allocation bias - and observational studies do not;
  • randomized trials, benefits over observational studies - double masking and placebo controls;
  • successful double masking - ruling out, confounding influence of participant and caregiver beliefs;
  • EBM claim, that mechanistic reasoning and expert judgment - deserve their position below comparative clinical studies in EBM hierarchy of evidence;
  • EBM movement, importance - of nonevidential roles of mechanistic reasoning and expert judgment;
  • applying evidence - to actual clinical decisions;
  • errors, known to philosophers - deriving an ‘ought’ from an ‘is’, patient circumstances and values considered;
  • expert judgment, integrating best evidence - with patient values and circumstances


This chapter contains sections titled:

  • Summary of Part II

  • Introduction to Part III