Where's the evidence? : controversies in modern medicine


    • Silverman, William A.


Where's the evidence? : controversies in modern medicine

William A. Silverman ; with a foreword by David L. Sackett

(Oxford medical publications)

Oxford University Press, c1998


Where is the evidence?

大学図書館所蔵 件 / 3



Essays and responses reprinted from various issues of Paediatric and perinatal epidemiology with updated commentary

Includes bibliographical references (p. [225]-247) and index



Medicine has developed many effective treatments, but new interventions have also produced unexpected harmful effects. This text argues that parallel comparisons must be made before new treatments are adopted to reduce the number of patients exposed to the unknown hazards of medical innovations. Additionally, the long-term consequences of new treatments must not be ignored. This book is a collection of critical and controversial essays on intractable ethical issues and evidence-based problems in modern medicine. Most, but not all, of the examples are taken from neonatal and perinatal medicine and were published over a period of 10 years together with responses in the journal "Paediatric and Perinatal Epidemiology". This book is intended for all those interested in the evidence-based medicine debate including epidemiologists, neonatalogists and those involved in clinical trials and health policy as well as medical ethicists, medical students and trainees.


  • Selective ethics
  • does a difference make a difference
  • prescription for disaster
  • therapeutic mystique
  • humane limits
  • intruding in private tragedies
  • the glut of information
  • betting on specified horses
  • begin with "if..."
  • Archie's scepticism
  • arbitrary vs discretionary decisions
  • bioengineering
  • "...disavowing the tree"
  • diffusing responsibility Weil's reply
  • Hawthorne effects
  • power plays
  • unbridled enthusiasm
  • caring and curing
  • on the edge
  • informing and consenting Weil's reply
  • lifesavers
  • belief and disbelief
  • preferences
  • Bradford Hill's doubts
  • more-informative abstracts
  • pain control in neonates
  • miraculous cures
  • observer bias
  • the gamekeeper's brouhaha
  • champing at the bit
  • piecemeal skirmishes
  • resolution of dilemma's Sinclair and Fowlie's reply Watts and Saigal's reply
  • "Fixing" human reproduction
  • justice defined as fairness
  • "Methods-based" reviews
  • non-replication of the replicable
  • who defines "futility" Goldworth and Benitz's reply
  • fitting targets in holes
  • medical "manners" on trial
  • sanction of whose beliefs and values?
  • mindness existence
  • interventions on an unprecedented scale
  • preoccupation with "autonomy"
  • a "win" in medical Russian roulette Lantos' reply

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