Epistemologies of evidence-based medicine: a plea for corpus-based conceptual research in the medical humanities

Jan Buts,Eivind Engebretsen,Mona Baker,Saturnino Luz

doi:10.1007/s11019-021-10027-2

Jan Buts, Eivind Engebretsen + Show 2 more

Open Access

https://doi.org/10.1007/s11019-021-10027-2

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Abstract

Evidence-based medicine has been the subject of much controversy within and outside the field of medicine, with its detractors characterizing it as reductionist and authoritarian, and its proponents rejecting such characterization as a caricature of the actual practice. At the heart of this controversy is a complex linguistic and social process that cannot be illuminated by appealing to the semantics of the modifier evidence-based. The complexity lies in the nature of evidence as a basic concept that circulates in both expert and non-expert spheres of communication, supports different interpretations in different contexts, and is inherently open to contestation. We outline a new methodology that combines a social epistemological perspective with advanced methods of corpus linguistics and elements of conceptual history to investigate this and other basic concepts that underpin the practice and ethos of modern medicine. The potential of this methodology to offer new insights into controversies such as those surrounding EBM is demonstrated through a case study of the various meanings supported by evidence and based, as attested in a large electronic corpus of online material written by non-experts as well as a variety of experts in different fields, including medicine.

Highlights

Ever since the rise of modern medical science in the early nineteenth century, medical practice has been closely associated with science and research, and evidence has grown to become a key term in modern medical discourse
In the evidencebased medicine (EBM) sense of the word, is mainly associated with randomized controlled trials (RCTs), i.e. comparative experimental intervention studies, which are considered the ‘gold standard’ for assessing cause-effect relationships between an intervention and its outcome; the findings generated by RCTs are likely to be closer to the true effect than the findings generated by other research methods (Evans 2003)
While our approach is empirical it is not bound to any experimental method, and where experimental philosophy has mostly used surveys, our study rather draws on corpus linguistics and conceptual history. Combining this social epistemological perspective with corpus linguistics and elements of conceptual history, we argue that the concept of evidence should not be studied solely in the restricted environments that lay claim to a specific notion of it

Summary

Introduction

Ever since the rise of modern medical science in the early nineteenth century, medical practice has been closely associated with science and research, and evidence has grown to become a key term in modern medical discourse. This article supports its plea for a new research strand in the medical humanities with a small case study of the linguistic patterning of evidence-based in a corpus of Internet English, and what this patterning reveals about the potential for this widely used term to generate different meanings in different contexts, in part because of the numerous meanings supported by each of its constituent elements (evidence and based).

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