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Causation and evidence-based practice - an ontological review

Kerry, Roger and Eriksen, Thor Eirik and Lie, Svein Anders Noer and Mumford, Stephen and Anjum, Rani Lill (2012) Causation and evidence-based practice - an ontological review. Journal of Evaluation in Clinical Practice, 18. pp. 1006-1012. ISSN 1365-2753

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This paper explores the nature of causation within the framework of evidence-based practice (EBP) for health care. The aims of the paper were first to define and evaluate how causation is presently accounted for in EBP; second, to present an alternative causal account by which health care can develop in both its clinical application and its scientific research activity. The paper was premised on the idea that causation underlies medical and health care practices and impacts on the way we understand health science research and daily clinical practice. The question of what causation is should therefore be of utmost relevance for all concerned with the science, philosophy and progress of EBP. We propose that the way causation is thought of in contemporaneous health care is exposed by evidential frameworks, which categorize research methods on their epistemological strengths. It is then suggested that the current account of causation is limited in respect of both the functionality of EBP, and its inherent scientific processes. An alternative ontology of causation is provided, which has its roots in dispositionalism. Here, causes are not seen as regular events necessitating an effect, but rather phenomena that are highly complex, context-sensitive and that tend towards an effect. We see this as a better account of causation for evidence-based health care.

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Item Type: Published Article or Volume
Eriksen, Thor
Lie, Svein Anders
Anjum, Rani
Keywords: causation, dispositions, evidence-based practice, health science, ontology, philosophy
Subjects: General Issues > Causation
Specific Sciences > Medicine
Depositing User: Dr. Rani Lill Anjum
Date Deposited: 25 Sep 2013 12:49
Last Modified: 25 Sep 2013 12:49
Item ID: 10011
Journal or Publication Title: Journal of Evaluation in Clinical Practice
Publisher: Wiley
Official URL:
Subjects: General Issues > Causation
Specific Sciences > Medicine
Date: 2012
Page Range: pp. 1006-1012
Volume: 18
ISSN: 1365-2753

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