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Article ID: CBB861466560

Measuring effectiveness (2015)

Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences
Volume: 54
Pages: 62-71
Publication date: 2015
Language: English

URI: https://www.sciencedirect.com/science/article/pii/S1369848615000837

DOI: 10.1016/j.shpsc.2015.06.003

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Measuring the effectiveness of medical interventions faces three epistemological challenges: the choice of good measuring instruments, the use of appropriate analytic measures, and the use of a reliable method of extrapolating measures from an experimental context to a more general context. In practice each of these challenges contributes to overestimating the effectiveness of medical interventions. These challenges suggest the need for corrective normative principles. The instruments employed in clinical research should measure patient-relevant and disease-specific parameters, and should not be sensitive to parameters that are only indirectly relevant. Effectiveness always should be measured and reported in absolute terms (using measures such as ‘absolute risk reduction’), and only sometimes should effectiveness also be measured and reported in relative terms (using measures such as ‘relative risk reduction’)—employment of relative measures promotes an informal fallacy akin to the base-rate fallacy, which can be exploited to exaggerate claims of effectiveness. Finally, extrapolating from research settings to clinical settings should more rigorously take into account possible ways in which the intervention in question can fail to be effective in a target population.

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