Research

 

My current research is concentrated in the philosophy of science and philosophy of medicine. It has two strands: disease and biomedicine, and epidemiology and evidence-based medicine (see below). I am currently writing a research monograph, tentatively titled The New Modern Medicine, that weaves these strands together to provide a book-length treatment of aspects of contemporary medicine that make it interesting and problematic, especially chronic disease and evidence-based 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 medical ontologies/classification systems, evidence evaluation and implementation, healthcare training, and public health and preventive medicine. Some of my papers are written for a philosophical audience, others for a healthcare audience.  

 
 

Disease and biomedicine

My research investigates the nature of chronic disease, disease classification, models of disease/prevention, and healthcare’s ‘new medical model’. 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:

“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.

 
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Epidemiology 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 theory of evidence is sorely missing in EBM, and how can it rescue clinical reasoning?

Select publications:

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

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

 
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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:

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.

 
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Other Publications

*for a full list of publications, please see my CV.

Peer-Reviewed Research Articles – Medicine:

“Endogenous opioid-induced neuroplasticity of dopaminergic neurons in the ventral tegmental area influences natural and opiate reward.” Journal of Neuroscience.

“Rhetoric and argumentation: how clinical practice guidelines think.” Journal of Evaluation in Clinical Practice.

“Pallidal deep brain stimulation for a case of hemidystonia secondary to a striatal stroke.” Stereotactic and Functional Neurosurgery.

Medication regimen complexity and the care of the chronically ill patient.” International Journal of Person-Centered Medicine.

Darwinian medicine: the past and present state of medicine’s unifying science.” University of Toronto Medical Journal.

 

Journal Commentaries and Editorials:

“Clinical judgment: Multidisciplinary perspectives.” Journal of Evaluation in Clinical Practice.

“Prediction in epidemiology and medicine.” Studies in History and Philosophy of Biological and Biomedical Sciences.

Logos, ethos and pathos in balance.” European Journal for Person Centered Healthcare.

 

Letters to the Editor:

“Discrepant expectations about benefits and harms.” JAMA Internal Medicine.

“Polypharmacy: prevention and management.” Canadian Medical Association Journal.

“Medication regimens.” Canadian Medical Association Journal.

 

Book Reviews:

“Making Medical Knowledge by M. Solomon.” Medical Humanities.

“Philosophy of Epidemiology by A. Broadbent.” Journal of Evaluation in Clinical Practice.