1. Introduction
1.1 Aims and Motivation
1.2 Overview of the Following Chapters
References
2. Theories of Confirmation in which Hypotheses do not have Probabilities
2.1 Hypothetico-Deductivism
2.2 Hempel's "Satisfaction" Theory
2.3 Mayo's Error-Statistical Theory
References
3. Theories of Confirmation in which Hypotheses have Probabilities, and Inference to the Best Explanation
3.1 General
3.2 Bayesianism
3.3 Achinstein's Theory of Evidence
3.4 Inference to the Best Explanation3.4.1 What is an Explanation?
3.4.2 Evidence, Hypothesis, and Explanation in Clinical Medical Science
References
4. Confirmation of Hypotheses in Clinical Medical Science
4.1 General
4.2 Therapeutic Hypotheses
4.2.1 Controlled Trials
4.2.2 N of 1 Trials
4.3 Etiologic Hypotheses
4.3.1 Cohort Studies
4.3.2 Case-Control Studies
4.3.3 Cross-Sectional Studies
4.3.4 Remarks on the Challenges of Etiologic Research
4.4 Diagnostic Hypotheses
References
5. A Weight of Evidence Account
5.1 General
5.2 Some Threats to Accuracy
5.2.1 Selection Bias
5.2.2 Information Bias
5.2.3 Confounding5.3 How is the Weight of Evidence Determined?
5.3.1 Cochrane Systematic Reviews
5.3.2 IARC Reviews
5.4 How is the Weight of Evidence Quantified?
5.5 The Importance of Accuracy
References
6. The Weight of Evidence Account Defended
6.1 General
6.2 Current Theories of Evidence are Unsatisfactory for Clinical Medical Science
6.3 The Weight of Evidence Account Remedies Deficiencies in other Accounts
6.4 The Weight of Evidence Account Explains the Case Studies
6.5 The Weight of Evidence Account Explains Efforts to Rank Evidence
References
7. Justification for the Hierarchical Pyramid of Evidence-Based Medicine and a Defense of Randomization
7.1 General
7.2 The Evolution of Treatments for Early Breast Cancer
7.2.1 Background
7.2.2 Early Studies
7.2.3 Controlled Trials in Clinical Medical Science Revisited
7.2.4 RCTs in Early Breast Cancer
7.3 Is Randomization Necessary?
7.4 A Defense of Randomization
7.5 Analysis of Evidence in Studies of Treatment for Early Breast Cancer
7.6 Some Issues in Generalizing the Results of RCTs in Clinical Medical Science
7.7 Why the Hierarchical Pyramid of EBM is Justified
References
8. Ethics and Evidence: Is Evidence from Randomized Controlled Trials Necessary to Firmly Establish a New Therapy?
8.1 General
8.2 ECMO
8.2.1 Background and RCTs of ECMO
8.2.2 Were the ECMO RCTs Necessary?
8.3 Carcinoma of the Anal Canal8.4 Disseminated Carcinoma of the Testis
8.5 Conclusions
References
Index
About the Author: John A. Pinkston, MD is a practicing Radiation Oncologist in Birmingham, AL. Dr. Pinkston graduated from University of Miami Leonard M Miller School of Medicine in 1968 and has been in practice for 49 years. He received his M.D. and Ph.D. (in philosophy) from the University of Miami. Dr. Pinkston completed residencies at the United States Naval Medical Center and at the Stanford University Medical Center. He received a Doctor of Public Health (Dr.P.H.) from the University of Alabama, Birmingham. Dr. Pinkston served as a Research Associate in the Department of Medicine, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan and as a Clinical Associate Professor of Radiation Oncology, University of Alabama, Birmingham.
