The concept of evidence-based practice is now applied in management, education, criminology, and social click here work. Yet, EBM has attracted controversy: its critics allege that EBM uses a narrow concept of evidence and a naive conception of the relationships between evidence, theory, and practice. They also contend that EBM presents itself as a radical restructuring of medical knowledge that discredits more traditional ways of knowing in medicine, largely in the interests of people with a particular investment

in the enterprise of large-scale clinical trials. Because EBM proposes a specific relationship between theory, evidence, and knowledge, its theoretical basis can be understood as an epistemological system. Undertaking epistemological inquiry is important because the adoption of a particular epistemological view defines how science is conducted.

Methods: In this paper, we challenge this critical view of EBM by examining how EBM fits into broad epistemological debates

within the philosophy of science. We consider how EBM relates to some classical debates regarding the nature of science and knowledge. We investigate EBM from the perspective of major epistemological theories (logical-positivism/inductivism, deductivism/falsificationism/theory-ladeness of observations, explanationism/holism, instrumentalism, underdetermination theory by evidence).

Results: We first explore the relationship between evidence and knowledge and discuss philosophical support for the main way that evidence is used in medicine: (1)

in the philosophical tradition that “”rational thinkers respect their evidence,”" BB-94 ic50 we show that EBM refers to making medical decisions that are consistent with evidence, (2) as a reliable sign, symptom, or mark to enhance reasonableness or truthfulness of some particular claim (“”evidence as a guide to truth”"), and (3) to serve as a neutral arbiter among competing views. Our analysis indicates that EBM does not have a rigorous epistemological stance. In fact, EBM enthusiastically draws on all major traditions of Cyclosporin A philosophical theories of scientific evidence.

Conclusions: Our findings indicate that EBM should not be construed as a new scientific or philosophical theory that changes the nature of medicine or our understanding thereof. Rather, we should consider EBM as a continuously evolving heuristic structure for optimizing clinical practice.”
“This study, carried out in a low tuberculosis (TB) prevalence country with high immigration rates from high TB prevalence countries, deals with the interferon-gamma release assay, QuantiFERON (R)-TB Gold In-Tube, for the diagnosis of latent TB infection (LTBI) in foreign-born children. The results of our study highlight the potential advantages and concerns of using a blood test for diagnosing LTBI in a ‘two-step’ strategy in foreign-born children.