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Book Details
Abstract
Measurement in Medicine brings together for the first time a range of philosophical essays on topics in the philosophy of epidemiology, epistemology of measurement, philosophy of health economics and health policy that address pressing questions of assessment and evaluation in medicine. Ranging from questions about the methodology of measuring instruments to the role of measurement in health policy decisions, this volume spans the essential topics for anyone interested in understanding the philosophical issues at stake in the growing industry of health and health care evaluation.
Leah McClimans's impressive collection presents a productive synergy of the wisdom of many leading figures in the philosophy of medicine and the philosophy of measurement. The contributors give timely philosophical attention to the increasing pervasiveness of measurement in all aspects of medicine. This book should be required reading for anyone concerned with the scientific development and social management of medicine.
Hasok Chang, Hans Rausing Professor of History and Philosophy of Science, University of Cambridge
This is an exciting collection of new essays exploring the use of outcome measurements in medicine. It demonstrates, in a variety of ways, that there are both epistemic and ethical choices to make in selecting outcome measurements as a basis for policy decisions. It is accessible to a multidisciplinary audience, including philosophers of science, ethicists, epidemiologists, and policy experts.
Miriam Solomon, Professor of Philosophy, Temple University
Leah McClimans is Associate Professor of Philosophy at the University of South Carolina.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Cover | i | ||
| Measurement in Medicine | ii | ||
| Measurement in Medicine | iv | ||
| Contents | vi | ||
| Introduction | viii | ||
| Measurement and Evidence-Based Medicine | ix | ||
| Measuring Instruments | xi | ||
| Measurement and Policy | xii | ||
| Future Directions | xiv | ||
| References | xv | ||
| Part I | 1 | ||
| Measurement and Evidence-Based Medicine | 1 | ||
| Chapter 1 | 3 | ||
| How Evidence-Based Medicine Highlights Connections between Measurement and Evidence | 3 | ||
| Evidence-Based Medicine, PatientCentered Care, and Implicit Bias Evidence-Based Medicine | 4 | ||
| Implicit Bias and Medicine | 5 | ||
| Implicit Bias and EBM | 6 | ||
| Implicit Bias and the Theory-Ladenness of Measurement in Medicine | 6 | ||
| Good and Bad Theory-Ladenness | 6 | ||
| Kuhn’s Three Forms of Theory-Ladenness in Measurement | 7 | ||
| Strategic Theory and the Theory-Ladenness of Evidence in EBM | 9 | ||
| Theory-Ladenness and the Evidence Hierarchy | 11 | ||
| The Evidence Hierarchy | 11 | ||
| Clinical Experience and Intuition | 12 | ||
| Pathophysiological Reasoning | 12 | ||
| Observational Studies | 13 | ||
| Randomized Controlled Trials | 14 | ||
| EBM and Evidence and Measurement | 17 | ||
| Notes | 18 | ||
| References | 19 | ||
| Chapter 2 | 21 | ||
| Can Causation Be Quantitatively Measured? | 21 | ||
| Estimating “Causal Effect” | 23 | ||
| Philosophy and General Causation | 27 | ||
| Preemption and the Potential Outcomes Approach | 29 | ||
| Quantitative Causal Claims as Counting Mechanisms | 32 | ||
| Conclusion | 33 | ||
| References | 34 | ||
| Chapter 3 | 35 | ||
| Absolute Measures of Effectiveness | 35 | ||
| Outcome Measures | 36 | ||
| Frequency of Use of Various Outcome Measures | 39 | ||
| Absolute Measures Are Superior to Relative Measures | 40 | ||
| The Myth of the Odds Ratio | 47 | ||
| Conclusion | 50 | ||
| Notes | 50 | ||
| References | 51 | ||
| Chapter 4 | 53 | ||
| A Causal Construal of Heritability Estimates | 53 | ||
| What Is Heritability? | 54 | ||
| The G×E | 56 | ||
| Challenge | 56 | ||
| The Additivity Reply | 57 | ||
| The G×E | 59 | ||
| Challenge | 59 | ||
| The Interdependent-Difference-Makers Reply | 60 | ||
| An Evaluation of the Reply | 63 | ||
| Lessons on Heritability | 64 | ||
| Conclusion | 66 | ||
| Notes | 66 | ||
| References | 67 | ||
| Part II | 71 | ||
| Measuring Instruments | 71 | ||
| Chapter 5 | 73 | ||
| A Theory of Measurement | 73 | ||
| Three Steps Characterizing the Concept | 74 | ||
| Representation | 78 | ||
| Measurement Procedures | 82 | ||
| Conclusion | 86 | ||
| Notes | 87 | ||
| References | 87 | ||
| Chapter 6 | 89 | ||
| Psychological Measures, Risk, and Values | 89 | ||
| Ontology and Psychological Measurement | 90 | ||
| Representational Measurement Theory | 92 | ||
| Classical Test Theory | 93 | ||
| Epistemic Risk and Psychological Measurement | 94 | ||
| Ordinal vs. Interval Measurement Scales | 95 | ||
| Validity | 97 | ||
| Nonepistemic Values and Psychological Measurement | 98 | ||
| Classical Test Theory Reconsidered | 99 | ||
| Latent Trait Theory Reconsidered | 101 | ||
| Conclusion | 102 | ||
| Notes | 103 | ||
| References | 103 | ||
| Chapter 7 | 107 | ||
| The Epistemological Roles of Models in Health Science Measurement | 107 | ||
| Background | 107 | ||
| Qualitative Models and Content Validity | 108 | ||
| Statistical Models and Comparability | 111 | ||
| Classical Test Theory | 111 | ||
| Rasch Measurement Theory | 113 | ||
| Theoretical Models and Accuracy | 115 | ||
| Conclusion | 118 | ||
| Notes | 118 | ||
| References | 119 | ||
| Chapter 8 | 121 | ||
| Measuring the Pure Patient Experience | 121 | ||
| Analysis of ESAS | 122 | ||
| First Presupposition: There is a Pure, Subjective Experience That Exists Objectively Outside and Beyond Language and Interpretat | 124 | ||
| First Argument | 125 | ||
| Second Argument | 126 | ||
| Second Presupposition: The Individual’s Knowledge about His or Her Experience Is Unique and Private and Can Best Be Captured by | 128 | ||
| References | 131 | ||
| Chapter 9 | 133 | ||
| Measurement, Multiple Concurrent Chronic Conditions, and Complexity | 133 | ||
| Demographic Transition | 134 | ||
| Classification Systems | 135 | ||
| Does the ICD Recognize MCCC/Complexity? | 136 | ||
| Why Does This Matter? | 137 | ||
| The Problem of Outcomes | 138 | ||
| MCCC Not the Only Issue; Complexity Now a Factor | 139 | ||
| Challenges in Measurement | 140 | ||
| The Ballung Nature of MCCC/Complexity | 143 | ||
| Moving Forward: A Measurement Agenda | 144 | ||
| Conclusion | 146 | ||
| References | 147 | ||
| Part III | 149 | ||
| Measurement and Policy | 149 | ||
| Chapter 10 | 151 | ||
| NICE’s Cost-Effectiveness Threshold | 151 | ||
| The Threshold: The Theory | 154 | ||
| The Threshold: The Practice | 155 | ||
| Justifying the Threshold? | 158 | ||
| From an Argument for Fixed Standards to the Setting of NICE’s Threshold | 159 | ||
| Can Anything Be Said in Favor of NICE’s Response to Claxton et al.? | 163 | ||
| Conclusion | 165 | ||
| Notes | 166 | ||
| References | 167 | ||
| Chapter 11 | 169 | ||
| Cost Effectiveness | 169 | ||
| Four Qualms Concerning Rationing by Cost Effectiveness | 169 | ||
| 1. S hould the objective of the health department be to promote the health of the nation’s population or to promote its welfare? | 170 | ||
| 2. S hould those whom it is less cost effective to treat get no treatment? | 170 | ||
| 3. S hould health-related resources be distributed in the most costeffective way when doing so aggravates inequalities? | 171 | ||
| 4. S hould the priority assigned to treatments depend exclusively on their cost and on the magnitude of the change in health tha | 171 | ||
| Changing the Measure of Effectiveness from Health to Well-Being | 172 | ||
| Changing the Measure of Effectiveness from Health to the “Social Value” of Health | 176 | ||
| Fairness, Severity, and Discrimination | 179 | ||
| Conclusions | 183 | ||
| Notes | 184 | ||
| References | 184 | ||
| Chapter 12 | 187 | ||
| The Value of Statistical Lives and the Valuing of Life | 187 | ||
| The Value of Statistical Lives | 189 | ||
| Formulation of the WTP Model of VSL | 190 | ||
| Measuring VSL | 192 | ||
| The Valuing of Life | 195 | ||
| Notes | 197 | ||
| References | 199 | ||
| Chapter 13 | 201 | ||
| How Good Decisions Result in Bad Outcomes | 201 | ||
| Effective Decision Making | 207 | ||
| The Group and the Individual | 211 | ||
| Solutions | 212 | ||
| References | 213 | ||
| Index | 215 | ||
| About the Contributors | 223 |