A Critical Social Science of Evidence-Based Healthcare
In many respects evidence-based healthcare is neither new nor are its philosophical underpinnings unique. Getting the best knowledge to the right people in a timely fashion is commonsense. Yet, this basic principle reflects a broader social movement in knowledge production and dissemination that has been emerging for centuries. Scientific inquiry, as it were, has become more systematic, globally connected and protocol driven over the course of the twentieth century. While scientific discoveries in the nineteenth and early twentieth centuries still often occurred in the context of a sole or renegade researcher/practitioner, the latter part of the twentieth century witnessed the global streamlining, enhanced connectivity and dramatic institutionalisation of scientific knowledge production. This fundamentally changed the way both science and medicine were practiced in terms of research priorities and practice guidelines. While changes were occurring within the scientific community more broadly, ‘modern’ medicine, given its prominence in the community, became centre stage in this broader social movement and philosophical shift toward regulation, abstraction and systematisation in research and clinical practice. As the systematisation of healthcare developed and matured over the last few decades of the twentieth century we saw the institutional emergence of ‘evidence-based medicine’ (EBM), followed by ‘evidence-based practice’ (EBP), and then many other evidence-based models in the health and social care professions. This book is about these movements – which we put under the umbrella of ‘evidence-based healthcare’ (EBHC) – and setting a broad sociological platform from which to understand how these new knowledge technologies impact upon the practice of health care.