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The use of mechanistic reasoning in assessing coronavirus interventions

Aronson, Jeffrey, Auker-Howlett, Daniel, Ghiara, Virginia, Kelly, Michael P, Williamson, Jon (2020) The use of mechanistic reasoning in assessing coronavirus interventions. Journal of Evaluation in Clinical Practice, . Article Number UNSPECIFIED. ISSN 1356-1294. E-ISSN 1365-2753. (doi:10.1111/jep.13438) (KAR id:82100)

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Abstract

Evidence-based medicine (EBM), the dominant approach to assessing the effectiveness of clinical and public health interventions, focuses on the results of association studies. EBM+ is a development of EBM that systematically considers mechanistic studies alongside association studies. In this paper we provide several examples of the importance of mechanistic evidence to coronavirus research. (i) Assessment of combination therapy for MERS highlights the need for systematic assessment of mechanistic evidence. (ii) That hypertension is a risk factor for severe disease in the case of SARS-CoV-2 suggests that altering hypertension treatment might alleviate disease, but the mechanisms are complex, and it is essential to consider and evaluate multiple mechanistic hypotheses. (iii) To be confident that public health interventions will be effective requires a detailed assessment of social and psychological components of the mechanisms of their action, in addition to mechanisms of disease. (iv) In particular, if vaccination programmes are to be effective, they must be carefully tailored to the social context; again, mechanistic evidence is crucial. We conclude that coronavirus research is best situated within the EBM+ evaluation framework.

Item Type: Article
DOI/Identification number: 10.1111/jep.13438
Uncontrolled keywords: Evidence-based medicine, coronavirus, mechanistic reasoning, mechanisms
Subjects: B Philosophy. Psychology. Religion > B Philosophy (General)
R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine > RA421 Public health. Hygiene. Preventive Medicine
Divisions: Faculties > Humanities > School of European Culture and Languages > Philosophy
Depositing User: Jon Williamson
Date Deposited: 14 Jul 2020 14:05 UTC
Last Modified: 27 Jul 2020 10:03 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/82100 (The current URI for this page, for reference purposes)
Williamson, Jon: https://orcid.org/0000-0003-0514-4209
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