Problems with using mechanisms to solve the problem of extrapolation

Jeremy Howick, Paul Glasziou, Jeffrey K. Aronson

Research output: Contribution to journalArticleResearchpeer-review

25 Citations (Scopus)

Abstract

Proponents of evidence-based medicine and some philosophers of science seem to agree that knowledge of mechanisms can help solve the problem of applying results of controlled studies to target populations ('the problem of extrapolation'). We describe the problem of extrapolation, characterize mechanisms, and outline how mechanistic knowledge might be used to solve the problem. Our main thesis is that there are four often overlooked problems with using mechanistic knowledge to solve the problem of extrapolation. First, our understanding of mechanisms is often (and arguably, likely to remain) incomplete. Secondly, knowledge of mechanisms is not always applicable outside the tightly controlled laboratory conditions in which it is gained. Thirdly, mechanisms can behave paradoxically. Fourthly, as Daniel Steel points out, using mechanistic knowledge faces the problem of the 'extrapolator's circle'. At the same time, when the problems with mechanistic knowledge have been addressed, such knowledge can and should be used to mitigate (nothing can entirely solve) the problem of extrapolation.

Original languageEnglish
Pages (from-to)275-291
Number of pages17
JournalTheoretical Medicine and Bioethics
Volume34
Issue number4
DOIs
Publication statusPublished - Aug 2013

Fingerprint

Health Services Needs and Demand
Evidence-Based Medicine
Steel
medicine

Cite this

Howick, Jeremy ; Glasziou, Paul ; Aronson, Jeffrey K. / Problems with using mechanisms to solve the problem of extrapolation. In: Theoretical Medicine and Bioethics. 2013 ; Vol. 34, No. 4. pp. 275-291.
@article{809ca44f2a6942c9bce4b6209fe10830,
title = "Problems with using mechanisms to solve the problem of extrapolation",
abstract = "Proponents of evidence-based medicine and some philosophers of science seem to agree that knowledge of mechanisms can help solve the problem of applying results of controlled studies to target populations ('the problem of extrapolation'). We describe the problem of extrapolation, characterize mechanisms, and outline how mechanistic knowledge might be used to solve the problem. Our main thesis is that there are four often overlooked problems with using mechanistic knowledge to solve the problem of extrapolation. First, our understanding of mechanisms is often (and arguably, likely to remain) incomplete. Secondly, knowledge of mechanisms is not always applicable outside the tightly controlled laboratory conditions in which it is gained. Thirdly, mechanisms can behave paradoxically. Fourthly, as Daniel Steel points out, using mechanistic knowledge faces the problem of the 'extrapolator's circle'. At the same time, when the problems with mechanistic knowledge have been addressed, such knowledge can and should be used to mitigate (nothing can entirely solve) the problem of extrapolation.",
author = "Jeremy Howick and Paul Glasziou and Aronson, {Jeffrey K.}",
year = "2013",
month = "8",
doi = "10.1007/s11017-013-9266-0",
language = "English",
volume = "34",
pages = "275--291",
journal = "Theoretical Medicine and Bioethics",
issn = "0166-2031",
publisher = "Springer",
number = "4",

}

Problems with using mechanisms to solve the problem of extrapolation. / Howick, Jeremy; Glasziou, Paul; Aronson, Jeffrey K.

In: Theoretical Medicine and Bioethics, Vol. 34, No. 4, 08.2013, p. 275-291.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Problems with using mechanisms to solve the problem of extrapolation

AU - Howick, Jeremy

AU - Glasziou, Paul

AU - Aronson, Jeffrey K.

PY - 2013/8

Y1 - 2013/8

N2 - Proponents of evidence-based medicine and some philosophers of science seem to agree that knowledge of mechanisms can help solve the problem of applying results of controlled studies to target populations ('the problem of extrapolation'). We describe the problem of extrapolation, characterize mechanisms, and outline how mechanistic knowledge might be used to solve the problem. Our main thesis is that there are four often overlooked problems with using mechanistic knowledge to solve the problem of extrapolation. First, our understanding of mechanisms is often (and arguably, likely to remain) incomplete. Secondly, knowledge of mechanisms is not always applicable outside the tightly controlled laboratory conditions in which it is gained. Thirdly, mechanisms can behave paradoxically. Fourthly, as Daniel Steel points out, using mechanistic knowledge faces the problem of the 'extrapolator's circle'. At the same time, when the problems with mechanistic knowledge have been addressed, such knowledge can and should be used to mitigate (nothing can entirely solve) the problem of extrapolation.

AB - Proponents of evidence-based medicine and some philosophers of science seem to agree that knowledge of mechanisms can help solve the problem of applying results of controlled studies to target populations ('the problem of extrapolation'). We describe the problem of extrapolation, characterize mechanisms, and outline how mechanistic knowledge might be used to solve the problem. Our main thesis is that there are four often overlooked problems with using mechanistic knowledge to solve the problem of extrapolation. First, our understanding of mechanisms is often (and arguably, likely to remain) incomplete. Secondly, knowledge of mechanisms is not always applicable outside the tightly controlled laboratory conditions in which it is gained. Thirdly, mechanisms can behave paradoxically. Fourthly, as Daniel Steel points out, using mechanistic knowledge faces the problem of the 'extrapolator's circle'. At the same time, when the problems with mechanistic knowledge have been addressed, such knowledge can and should be used to mitigate (nothing can entirely solve) the problem of extrapolation.

UR - http://www.scopus.com/inward/record.url?scp=84881157827&partnerID=8YFLogxK

U2 - 10.1007/s11017-013-9266-0

DO - 10.1007/s11017-013-9266-0

M3 - Article

VL - 34

SP - 275

EP - 291

JO - Theoretical Medicine and Bioethics

JF - Theoretical Medicine and Bioethics

SN - 0166-2031

IS - 4

ER -