Topoi

, Volume 33, Issue 2, pp 313–322 | Cite as

Down with the Hierarchies

Article

Abstract

Evidence hierarchies are widely used to assess evidence in systematic reviews of medical studies. I give several arguments against the use of evidence hierarchies. The problems with evidence hierarchies are numerous, and include methodological shortcomings, philosophical problems, and formal constraints. I argue that medical science should not employ evidence hierarchies, including even the latest and most-sophisticated of such hierarchies.

Keywords

Evidence Causality Evidence hierarchies Medicine Randomized trials Mechanisms Amalgamating evidence Quality assessment tools RCTs Meta-analysis 

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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Institute for the History and Philosophy of Science and TechnologyUniversity of TorontoTorontoCanada
  2. 2.Department of PhilosophyUniversity of UtahSalt Lake CityUSA

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