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Equality, Efficiency, and Effectiveness: Going Beyond RCTs in A. L. Cochrane’s Vision of Healthcare
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SYSNO ASEP 0499642 Druh ASEP J - Článek v odborném periodiku Zařazení RIV J - Článek v odborném periodiku Poddruh J Článek ve WOS Název Equality, Efficiency, and Effectiveness: Going Beyond RCTs in A. L. Cochrane’s Vision of Healthcare Tvůrce(i) Trnka, Susanna (SOU-Z) ORCID, SAI
Stöckelová, Tereza (SOU-Z) RID, ORCID, SAIZdroj.dok. Sociology of Health & Illness. - : Wiley - ISSN 0141-9889
Roč. 41, č. 2 (2019), s. 234-248Poč.str. 15 s. Forma vydání Tištěná - P Jazyk dok. eng - angličtina Země vyd. GB - Velká Británie Klíč. slova Czech Republic ; complementary and alternative medicine ; evidence-based medicine Vědní obor RIV AO - Sociologie, demografie Obor OECD Sociology CEP GA15-16452S GA ČR - Grantová agentura ČR Institucionální podpora SOU-Z - RVO:68378025 UT WOS 000457796400003 EID SCOPUS 85052465354 DOI 10.1111/1467-9566.12817 Anotace A. Cochrane’s Effectiveness and Efficiency frequently appears as a key reference in debates over, and a justification for, contemporary evidence-based medicine. Cochrane’s concern in this text with the equality of care as the ultimate rationale for why effectiveness and efficiency of cure are needed has, however, largely disappeared from debate. In this article, we reconsider Cochrane’s approach through the use of case studies of plural forms of medicine in the Czech Republic, namely traditional Chinese medicine, homeopathy and spa care. In addition to bringing equality back into the picture, we also identify four expansions to Cochrane’s original vision arising from the difficulties of separating cure from care, the overlap between prevention and cure, the complex actions of some multi-faceted therapies, and recent reconceptualizations of the placebo effect. In conclusion, we suggest that instead of the widely used strictly vertical 'evidence pyramid', a descriptor of the horizontal and additive ordering of evidence might be more appropriate. We also argue that in healthcare systems characterized by a multiplicity of approaches, if we want to truly benefit from this heterogeneity, we must take seriously each medical tradition’s approaches to prevention, cure, care, as well as efficiency, efficacy, and equality. Pracoviště Sociologický ústav Kontakt Eva Nechvátalová, eva.nechvatalova@soc.cas.cz, Tel.: 222 220 924 / linka 351 Rok sběru 2019
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