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Master's Dissertation
DOI
Document
Author
Full name
Alvaro Hadad Filho
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2018
Supervisor
Committee
Mariconda, Pablo Ruben (President)
Ayres, Jose Ricardo de Carvalho Mesquita
Caponi, Gustavo Andres
Plastino, Caetano Ernesto
Title in Portuguese
Considerações sobre a estatística médica: uma análise crítica do movimento "Medicina baseada em evidências"
Keywords in Portuguese
Eficácia terapêutica
Estatística Médica
Filosofia da ciência
Medicina baseada em evidências
Abstract in Portuguese
O movimento "Medicina baseada em evidências (EBM), surgido na década de 1990, encontrou rápida aceitação por parte da comunidade médica e dos sistemas de saúde. Entre suas principais características, encontram-se a exigência de que a prática clínica seja baseada na melhor evidência disponível, a hierarquização da evidência, a valorização dos ensaios clínicos e, sobretudo, o recurso extensivo a procedimentos de análise estatística. Neste trabalho, apresentamos a EBM, descrevemos seus conceitos e procedimentos centrais e indicamos alguns de seus antecedentes históricos. Damos especial atenção aos conceitos de randomização, significância estatística, evidência científica e eficácia terapêutica. Finalmente, desenvolvemos uma crítica às concepções de cientificidade e progresso defendidas pela EBM e a utilizamos como ponto de partida para tecermos considerações gerais acerca do estatuto epistemológico da medicina, do progresso médico e das funções que a estatística desempenha na medicina contemporânea.
Title in English
Thoughts on medical statistics: a critical analysis of "Evidencebased medicine"
Keywords in English
Evidence-based medicine
Medical statistics
Philosophy of science
Therapeutic efficacy
Abstract in English
Evidence-based medicine (EBM) is a medical movement whose first appearance dates back to the 1990s. Since then, it has received wide acceptance from the medical community and international health systems. Among its most important characteristics, it is possible to indicate the demand to base the clinical practice on the best current evidence, the hierarchies of evidence, the valorisation of the randomized-controlled trials, and, especially, the extensive recourse to procedures of statistical analysis. This Masters dissertation is intended to present the EBM movement, describe its main concepts and procedures, and identify some of its historical backgrounds. Special consideration is given to the concepts of randomization, statistical significance, scientific evidence, and therapeutic efficacy. Finally, we present some criticisms on the conceptions of medical science and medical progress defended by EBM proponents. We then use them as a starting point for the development of our own considerations about the epistemological status of medicine, the medical progress and the advancement of knowledge in the contemporary medical sciences.
 
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Publishing Date
2019-05-17
 
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