With new methods of treatment standardisation resulting in various benefits for patient outcomes, evidence-based medicine and evidence-based practice have emerged as defining features of western healthcare provision in recent years. Most health professions are now adopting some form of 'evidence-based' framework for clinical training and practice. However, the rise of evidence-based healthcare has drawn sustained criticism regarding the limits of trial based evidence, the reductive character of epidemiological study designs, and the potential for an erosion of the importance of lay perspectives and clinical judgement. Evidence-Based Healthcare in Context introduces readers to the social, cultural and historical underpinnings of 'evidence' in healthcare, critically examining questions about what constitutes ’evidence’ and ’effectiveness’ from perspectives outside medicine, including those of patients, complementary medicine and midwifery. It focuses on the application of contemporary theoretical debates around the nature of medical and health knowledge, providing readers with a series of critical analyses of the production, application and translation of 'evidence' in a range of healthcare contexts. Featuring cutting edge work from leading social scientists in the UK, US, Canada, Norway, Australia and New Zealand, this volume draws on the latest empirical research to provide a thorough critical overview of this important field of health research.
'The idea of supporting clinical practices with evidence is all too often uncritically accepted as a reality, equally appropriate and achievable in all contexts without consequence. This excellent collection reminds us that evidence is socially and culturally produced and relative and that the very idea of Evidence-Based Healthcare can marginalize certain practices, diseases, research disciplines and methods. This is a must-read for students, researchers and health professionals.' Gavin Andrews, McMaster University, Canada 'The long-standing tradition in sociology of critically examining the training of health professionals and the process of knowledge creation in the health field is given a new angle - how to utilise the different forms of available knowledge to most effectively care for patients. Developing critical social science perspectives, this book provides an innovative set of reflections on the various strategies health professionals utilize to retain their clinical integrity in the face of evidence-based reductions.' Nelson Filice de Barros, Universidade Estadual de Campinas, Brazil 'This book, edited by two Australian scholars, […] provides many fresh views that complement the general picture of EBM and related areas. It demonstrates very well the nature of EBM as a social movement and the ’bumpy road’ of the implementation of EBM and other models… The empirical part of the volume provides some really interesting and also surprising results. One example is from Stefan Timmermans and Alison Angell who show that the introduction of EBM in post-graduate medical education may generate new forms of uncertainty, which is, of course, contrary to the original idea of EBM… the book is essential reading for anybody interested in an ’outsider’s’ critical look at evidence-based healthcare.' Medicine, Health Care and Philosophy
Contents: A critical social science of evidence-based healthcare; Part I Evidence in Cultural and Theoretical Context: Evidence-based medicine, clinical uncertainty, and learning to doctor, Stefan Timmermans and Alison Angell; Resisting stratification: imperialism, war machines and evidence-based practice, Dave Holmes and Patrick O’Byrne. Part II Evidence in the Clinic: Communally-based evidence in the emerging practice of aorta implant surgery, Berit Brattheim, Arild Faxvaag and Aksel Tjora; Embodied, embedded and encoded knowledge in practice: the role of clinical interpretation in neurorehabilitiation, Rob Flynn, Joanne Greenhalgh, Andrew Long and Sarah Tyson; The histories and cultures of evidence utilisation: the cases of medical oncology and haematology, Alex Broom and Jon Adams. Part III Evidence on the Margins: Evidence-based health care and complementary and alternative medicine, Kevin Dew; Patient understandings of evidence and therapeutic effectiveness, Alex Broom and Philip Tovey; Evidence-based paradigms and contemporary midwifery, Caroline Homer and Alex Broom; Evidence-based healthcare: the future research agenda, Anne-Grete Sandaunet and Evan Willis; Index.