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Empiricalism. Under or Over rated

Discussion in 'General Issues and Discussion Forum' started by Robertisaacs, Feb 12, 2008.


Should empiricalism be given more credit than it presently is in podiatry

  1. Yes, empiricalism deserves more credit

    5 vote(s)
  2. No. EBM is the gold standard we should strive for

    5 vote(s)

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    I put this poll on orthopeds. I'd be interested to see how it fairs here.

    We've touched on this on several threads.

    Empirical - based on what is experienced or seen rather than on theory:

    Martin harvey



    Robert Isaacs

    An alternitive therapist (forget which flavour) on finding no significant difference between his treatment and the control group in a controlled dbl blinded study!

    Empiricalism is the antithesis of Evidence based medicine (EBM). Its the premise of doing what works for you, what has worked in the past, what works in your experiance rather than what you base on Evidence.

    We all use empiricalism to a greater of lesser degree. Anyone who claims otherwise should consider where they read the Double blinded study which shows that removing corns releives pain (except simon, who'll tell me about the one which showed it does'nt)

    Alternitive therapies are based on empiricalism. Whilst some would disagree the fact is that when something has a solid basis in evidence it ceases to become "alternative medicine" and becomes mainline.

    Empiricalism grows with experiance. EBM requires academics to make it work. Any practitioner in any discipline regardless of their initial training / qualification will eventually develop expertise based on empiricalism (if they are reasonably observant and intelligent).

    Empiricalism has its flaws. It renders its proponents vulnerable to all manner of bias and heuristics (the Tam 10 know what i'm talking about now). On the basis of empiricalism people have placed bumpy plugs in their ears to surpress appitite, paid upwards of £3000 to have their "cracked aura" repaired and sought to cure their heel pain by placing a flat copper plate under their heel. And the vendors of these things often beleive that what they are doing is working!

    EBM has its flaws. Followed dogmatically it will paralyse its proponent to a very small number of interventions which carry the highest level of evidence and can blind people to the possibilities of new techniques.

    EBM is the "gold standard" required for medicine and is generally more respected.

    Empiricalism is the "starter motor" for EBM. Without it the studies would simply never happen!

    I invite thoughts / opinions / discussion.

  2. DaVinci

    DaVinci Well-Known Member

    The only problem I have with empiricalism is that there is a very fine line between it and snake oil salesman.
    Last edited by a moderator: Feb 12, 2008
  3. Admin2

    Admin2 Administrator Staff Member

  4. Craig Payne

    Craig Payne Moderator

    Surely a bigger issue is not the either or, but the use (or misue) of one or the other when it suits oneself, depending on the issue or point one is trying to make.

    The answer must lie in the accepted definition of evidence based medicine (a definition that those who do not support EBM choose to ignore when it suits them). Sackett (EBM god) describes EBM as:
    Notice the bits I highlighted .... ie good EBM includes empiricism!
  5. Mart

    Mart Well-Known Member

    Thanks Craig

    That is the most complete, concise and clearly thought out response to this issue I have seen, and one which I have never really been able to satisfactorily figure out myself



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  6. Agreed. Thanks Craig.

    For me the best part of that definition is
    Much of the problem (IMHO) with Empiricalism, particularly the snake oil salesman that Da'vinchi mentioned occurs when somebody presumes that Empiricalism alone is adequate and the it stands without "systematic clinical research".

    One of the questions i always ask when considering a modality is if there is no research backing, why not? If the modality works there will usually be somebody seeking to make money out of it and who will be all to happy to fund research. Of course this can lead to bias...

    I beleive a system has been proposed where by there is a compulsary clinical trial database. In this system before undertaking a trial you must register it. If your findings do not go the way you want you cannot then simply sit on them, studies which show no significant outcome would be made public as well as those which do. This strikes me as a very sensible idea.


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