Expertise in evidence-based medicine: a tale of three models

Abstract Background Expertise has been a contentious concept in Evidence-Based Medicine (EBM). Especially in the early days of the movement, expertise was taken to be exactly what EBM was rebelling against—the authoritarian pronouncements about “best” interventions dutifully learned in medical schoo...

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Main Author: Sarah Wieten
Format: Article
Language:English
Published: BMC 2018-02-01
Series:Philosophy, Ethics, and Humanities in Medicine
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13010-018-0055-2
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author Sarah Wieten
author_facet Sarah Wieten
author_sort Sarah Wieten
collection DOAJ
description Abstract Background Expertise has been a contentious concept in Evidence-Based Medicine (EBM). Especially in the early days of the movement, expertise was taken to be exactly what EBM was rebelling against—the authoritarian pronouncements about “best” interventions dutifully learned in medical schools, sometimes with dire consequences. Since then, some proponents of EBM have tried various ways of reincorporating the idea of expertise into EBM, with mixed results. However, questions remain. Is expertise evidence? If not, what is it good for, if anything? Methods In this article, I describe and analyze the three historical models of expertise integration in EBM and discuss the difficulties in putting each into practice. I also examine accounts of expertise from disciplines outside of medicine, including philosophy, sociology, psychology, and science and technology studies to see if these accounts can strengthen and clarify what EBM has to say about expertise. Results Of the accounts of expertise discussed here, the Collins and Evans account can do most to clarify the concept of expertise in EBM. Conclusions With some additional clarification from EBM proper, theoretical resources from other disciplines might augment the current EBM account of expertise.
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spelling doaj.art-53719293dbea4d53bff68c096dc8fb212022-12-21T19:11:01ZengBMCPhilosophy, Ethics, and Humanities in Medicine1747-53412018-02-011311710.1186/s13010-018-0055-2Expertise in evidence-based medicine: a tale of three modelsSarah Wieten0Philosophy Department, Indiana University of PennsylvaniaAbstract Background Expertise has been a contentious concept in Evidence-Based Medicine (EBM). Especially in the early days of the movement, expertise was taken to be exactly what EBM was rebelling against—the authoritarian pronouncements about “best” interventions dutifully learned in medical schools, sometimes with dire consequences. Since then, some proponents of EBM have tried various ways of reincorporating the idea of expertise into EBM, with mixed results. However, questions remain. Is expertise evidence? If not, what is it good for, if anything? Methods In this article, I describe and analyze the three historical models of expertise integration in EBM and discuss the difficulties in putting each into practice. I also examine accounts of expertise from disciplines outside of medicine, including philosophy, sociology, psychology, and science and technology studies to see if these accounts can strengthen and clarify what EBM has to say about expertise. Results Of the accounts of expertise discussed here, the Collins and Evans account can do most to clarify the concept of expertise in EBM. Conclusions With some additional clarification from EBM proper, theoretical resources from other disciplines might augment the current EBM account of expertise.http://link.springer.com/article/10.1186/s13010-018-0055-2Evidence-based medicineExpertiseEvidenceAmalgamation
spellingShingle Sarah Wieten
Expertise in evidence-based medicine: a tale of three models
Philosophy, Ethics, and Humanities in Medicine
Evidence-based medicine
Expertise
Evidence
Amalgamation
title Expertise in evidence-based medicine: a tale of three models
title_full Expertise in evidence-based medicine: a tale of three models
title_fullStr Expertise in evidence-based medicine: a tale of three models
title_full_unstemmed Expertise in evidence-based medicine: a tale of three models
title_short Expertise in evidence-based medicine: a tale of three models
title_sort expertise in evidence based medicine a tale of three models
topic Evidence-based medicine
Expertise
Evidence
Amalgamation
url http://link.springer.com/article/10.1186/s13010-018-0055-2
work_keys_str_mv AT sarahwieten expertiseinevidencebasedmedicineataleofthreemodels