Identifying Effectiveness in ''The Old Old
Principles and Values in the Age of Clinical Trials
Bibliographic Data
| ID | 5337280 |
|---|---|
| Authors | Catherine M Will, Catherine Will (0000-0001-7224-714X, University of Sussex, corresponding author) |
| Year | 2009 |
| Volume | 34 |
| Issue | 5 |
| Pages | 607-628 |
| Publication date | 2009-09-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Science Technology & Human Values (JOURNAL) |
| Journal identifiers | ISSN: 0162-2439 • E-ISSN: 1552-8251 |
| Publisher | SAGE Publications Inc (PUBLISHER) |
| DOI | 10.1177/0162243909340261 |
| OpenAlex | W2126086712 |
| Language | EN |
| Citations received | 10 |
| References cited | 23 |
This article explores some implications of the increasing reliance on clinical trials in contemporary health care, particularly health care payers' efforts to use them in the so-called fourth hurdle decisions. How do these agencies manage medical uncertainty given the desire to produce clear guidelines for clinicians? Their solutions take account of trials in at least two ways, reflecting broader debates about the meaning of these medical experiments. Trials can be read as either ''proofs of protocol''-straightforward guides to action with individual drugs in specific populations-or ''proofs of principle''- where extrapolation is made possible through an appeal to underlying biological mechanisms. These contrasting readings of trials are illustrated with reference to guidelines on heart disease prevention/cholesterol reduction using statins among the elderly in North America and the United Kingdom. Uncertainty in these cases does not lead to inertia but solutions use different fixed points to aid navigation, including both physiological principles and moral values
Alternative medicine · Appeal · Clinical trial · Health care · Mathematical proof · Pathology · Political science · Health Systems, Economic Evaluations, Quality of Life · Healthcare cost, quality, practices · Law · Lipoproteins and Cardiovascular Health · Medicine · Psychology
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Being ‘evidence-based’ in the absence of evidence
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Experimental heterogeneity and standardisation
The logic of strategic ignorance
Knowing Times
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The Emergence of Statistical Objectivity
Trust in Numbers
‘But if you look at the coronary anatomy …’
The Alchemy of Clinical Trials
The Global Challenge of Health Care Rationing
The Politics of Therapeutic Evaluation
Health and efficiency
The Politics of Evidence-Based Medicine in the United Kingdom
The Construction of Lay Expertise
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Rebirthing the Clinic
Regulatory objectivity and the generation and management of evidence in medicine
Clinical autonomy, individual and collective
Health technology adoption and the politics of governance in the UK
Resisting Evidence
The Q(u)ALYfying Hand
Arguing about the evidence
Openness and Specialisation
| Unique citing works | 10 |
|---|---|
| Citations per year | 0,67 |
| Citation span | 2011 - 2026 (16) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 10 |