Philosophers of science have recently made very bold claims about the evidential role of mechanisms, claiming that it is required for establishing efficacy, effectiveness, and for discovering treatments. However evidence of mechanisms is inherently difficult to obtain. In previous papers, Dr Howick have shown that evidence of mechanisms is not very helpful for establishing efficacy or effectiveness. There is a growing body of empirical evidence showing that clinical observations (without knowledge of mechanisms) are the most efficient way for generating hypotheses about new treatments. Therefore, Dr Howick will argue, evidence of mechanisms is not required for medical treatment discovery.
Abstract:
Mechanistic approaches to causality is receiving increasing attention from philosophers of science. In this lecture, Dr Howick will explore a related role for evidence of mechanisms that has not yet been widely discussed, namely the role of mechanisms in generating hypotheses that lead to clinically beneficial medical treatments.
Because the hypothesis about the success of the treatment also provides some evidence for the benefits of the treatment, evidence about the relative success of each method for generating eventually successful hypotheses is what Schaffner might call a ‘weak evaluation procedure’. Broadly speaking there are two overlapping methods for generating hypotheses about treatment discovery: basic science research (usually into underlying mechanisms) and clinical observations. Numerous studies have empirically investigated the success of these two methods by taking a clinically beneficial treatment as a startingpoint, then examining the historical development of the treatment to see whether the hypothesis about the treatment’s effectiveness arose from basic research or from clinical observations. Aside from an early study, there is a growing consensus that hypotheses about beneficial treatments are more likely to arise from clinical observations than the basic Sciences.
About Dr Jeremy Howick:
Dr Jeremy Howick is Senior Research Associate, Faculty of Philosophy and Research Fellow, Department of Primary Care Health Sciences at the University of Oxford, and Fellow of Kellogg College. Dr. Howick's research draws on his interdisciplinary training as a philosopher of science and clinical epidemiologist. He has two related areas of interest:
- Evidence-Based Medicine (EBM): EBM 'hierarchies' of evidence, clinical epidemiology, and how point of care tests might improve practice.
- Philosophy of medicine: the epistemological foundations of Evidence-Based Medicine, the ethics of placebos in trials and practice.