| Clinical intuition versus statistics: different modes of tacit knowledge in clinical epidemiology and evidence-based medicine. | |
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MedLine Citation:
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PMID: 19548116 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-based medicine movement has not succeeded in shaking off an epistemological critique derived from the experiential or tacit dimensions of clinical reasoning about particular individuals. This critique claims that the evidence-based medicine model does not take account of tacit knowing as developed by the philosopher Michael Polanyi. However, the epistemology of evidence-based medicine is premised on the elimination of the tacit dimension from clinical judgment. This is demonstrated through analyzing the dichotomy between clinical and statistical intuition in evidence-based medicine's epistemology of clinical reasoning. I argue that clinical epidemiology presents a more nuanced epistemological model for the application of statistical epidemiology to the clinical context. Polanyi's theory of tacit knowing is compatible with the model of clinical reasoning associated with clinical epidemiology, but not evidence-based medicine. |
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Authors:
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Hillel D Braude |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Theoretical medicine and bioethics Volume: 30 ISSN: 1573-0980 ISO Abbreviation: Theor Med Bioeth Publication Date: 2009 |
Date Detail:
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Created Date: 2009-07-02 Completed Date: 2009-08-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9805378 Medline TA: Theor Med Bioeth Country: Netherlands |
Other Details:
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Languages: eng Pagination: 181-98 Citation Subset: E; IM |
Affiliation:
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Biomedical Ethics Unit, McGill University, 3647 Peel Street, Montreal, QC H3A1X1, Canada. hillel.braude@mail.mcgill.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Data Interpretation, Statistical* Decision Making Epidemiology* Evidence-Based Medicine* Humans Intuition* Judgment Knowledge Problem Solving Randomized Controlled Trials as Topic* Thinking* |
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