Jonathan Fuller (University of Toronto)
Much skepticism about contemporary medical evidence concerns its relevance for individual patients. Evidence-based medicine's (EBM's) theory of evidence has an epidemiologic orientation, focusing on epidemiological, population-level outcomes. It also has an ontic orientation, concerned ultimately with measuring these outcomes. It fails to address questions like: how strongly should the physician believe that the treatment will prevent/cause this patient's death? I propose a rival Personal Evidential Support Theory (PEST) in which medical evidence confirms (supports) or disconfirms 'personal' patient-relevant hypotheses. I compare PEST to EBM's theory through the case of cholesterol-lowering therapy and argue that PEST partly overcomes EBM's relevance crisis.
