Research

My current research focuses on the philosophy of science and philosophy of medicine. It has two strands: disease and biomedicine, and epidemiology and evidence-based medicine (see below). With the support of a grant from the National Institutes of Health and the National Library of Medicine, I am currently doing research for a book, tentatively titled The New Modern Medicine: Disease, Evidence, and Epidemiological Medicine, that weaves these strands together to provide a treatment of contemporary scientific medicine. I have also done research in health professions education on social sciences and humanities in medical training (below), and research in neuroscience. Links to my articles can be found on this page.

I develop implications of my work for science and healthcare. My research has particular relevance for bioethics, medical ontologies/classification systems, evidence evaluation and implementation, healthcare training, science communication, and public health and preventive medicine. Some of my papers are written for a philosophical audience, others for a healthcare or general audience.

Disease and biomedicine

My research investigates the nature of chronic disease and epidemics, disease classification, models of disease and prevention, and healthcare’s ‘new medical model’. How can we explain and model epidemics? What are chronic diseases, why are they chronic and incurable? How does the way we classify diseases affect whether they have a universal or a multifactorial etiology? How should we model prevention of disease versus cure? What is the dominant model of healthcare, and what are its essential elements?

Select Publications:

“Epidemics from the population perspective.” Philosophy of Science.

“Preventive and curative medical interventions.” Synthese.

“What are the COVID-19 models modeling (philosophically speaking).” History and Philosophy of the Life Sciences.

“What are chronic diseases?” Synthese.

“Universal etiology, multifactorial diseases, and the constitutive model of disease classification.” Studies in History and Philosophy of Biological and Biomedical Sciences.

“The new medical model: a renewed challenge for biomedicine.” Canadian Medical Association Journal. [Replies: James Marcum; Benjamin Chin-Yee.]

“Poverty as a medical condition.” Canadian Medical Association Journal.

Evidence and Evidence-based medicine

My research investigates the role of meta-research in clinical reasoning, causal inference in epidemiologic studies, predicting and extrapolating from epidemiologic studies, and evidence and risk in evidence-based medicine (EBM). What role should meta-research play in evaluating therapies? How do randomized trials really work? How do we extrapolate results from epidemiologic studies and apply them to individual patients? What is ‘medical risk’? What principles of evidence are missing in EBM?

Select publications:

“The argument framework is a flexible approach to evidence in healthcare.” Nature Medicine.

“Epidemiologic evidence: use at your own risk?” Philosophy of Science.

“The myth and fallacy of simple extrapolation in medicine.” Synthese.

“The confounding question of confounding causes in randomized trials.” British Journal for the Philosophy of Science.

“Meta-research evidence for evaluating therapies.” Philosophy of Science.

“The Risk GP Model: the standard model of prediction in medicine.” Studies in History and Philosophy of Biological and Biomedical Sciences. [Discussed in: “Evidence-based medicine lacks solid supporting evidence.” Science News.]

“Translating trial results in clinical practice: the Risk GP Model.” Journal of Cardiovascular Translational Research.

“Randomized controlled trials in the West African Ebola virus outbreak.” Clinical Trials.

“Rationality and the generalization of randomized controlled trial evidence.” Journal of Evaluation in Clinical Practice.

“Renaissance or reformation for evidence based medicine?” British Medical Journal.

Health professions education

My research investigates the role of the social sciences and humanities (especially philosophy) in health professions training. How can philosophy, history, and literature help us train better health providers?

Select publications:

“Choosing words wisely: residents' use of rhetorical appeals in conversations about unnecessary tests.” Academic Medicine.

“Medical history in Canadian undergraduate medical education, 1939-2012.” Canadian Bulletin of Medical History.

“The art of medicine.” Canadian Medical Association Journal.

“Social science and humanities research in MD-PhD training.” Academic Medicine.

“Doctors must be trained to assess credibility.” Canadian Medical Association Journal.