Evaluating Evidence of Mechanisms in Medicine

Description

This book is open access under a CC BY license. This book is the first to develop explicit methods for evaluating evidence of mechanisms in the field of medicine. It explains why it can be important to make this evidence explicit, and describes how to take such evidence into account in the evidence appraisal process. In addition, it develops procedures for seeking evidence of mechanisms, for evaluating evidence of mechanisms, and for combining this evaluation with evidence of association in order to yield an overall assessment of effectiveness. Evidence-based medicine seeks to achieve improved health outcomes by making evidence explicit and by developing explicit methods for evaluating it. To date, evidence-based medicine has largely focused on evidence of association produced by clinical studies. As such, it has tended to overlook evidence of pathophysiological mechanisms and evidence of the mechanisms of action of interventions. The book offers a useful guide for all those whose work involves evaluating evidence in the health sciences, including those who need to determine the effectiveness of health interventions and those who need to ascertain the effects of environmental exposures. Front Matter ....Pages i-xviii Front Matter ....Pages 1-1 Introduction (Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly et al.)....Pages 3-9 An Introduction to Mechanisms (Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly et al.)....Pages 11-21 How to Consider Evidence of Mechanisms: An Overview (Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly et al.)....Pages 23-33 Front Matter ....Pages 35-35 Tools (Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly et al.)....Pages 37-59 Front Matter ....Pages 61-61 Gathering Evidence of Mechanisms (Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly et al.)....Pages 63-75 Evaluating Evidence of Mechanisms (Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly et al.)....Pages 77-90 Using Evidence of Mechanisms to Evaluate Efficacy and External Validity (Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly et al.)....Pages 91-98 Front Matter ....Pages 99-99 Assessing Exposures (Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly et al.)....Pages 101-110 Assessing Mechanisms in Public Health (Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly et al.)....Pages 111-120 Particularisation to an Individual (Veli-Pekka Parkkinen, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly et al.)....Pages 121-125