Semmelweis’s methodology from the modern stand-point: intervention studies and causal ontology

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T1 - Semmelweis’s methodology from the modern stand-point: intervention studies and causal ontology

AU - Persson, Johannes

N1 - The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: The Vårdal Institute (016540000), Department of Philosophy (015001000), Theoretical Philosophy (015001002)

PY - 2009

Y1 - 2009

N2 - Semmelweis’s work predates the discovery of the power of randomization in medicine by almost a century. Although Semmelweis would not have consciously used a randomized controlled trial (RCT), some features of his material—the allocation of patients to the first and second clinics—did involve what was in fact a randomization, though this was not realised at the time. This article begins by explaining why Semmelweis’s methodology, nevertheless, did not amount to the use of a RCT. It then shows why it is descriptively and normatively interesting to compare what he did with the modern approach using RCTs. The argumentation centres on causal inferences and the contrast between Semmelweis’s causal concept and that deployed by many advocates of RCTs. It is argued that Semmelweis’s approach has implications for matters of explanation and medical practice.

AB - Semmelweis’s work predates the discovery of the power of randomization in medicine by almost a century. Although Semmelweis would not have consciously used a randomized controlled trial (RCT), some features of his material—the allocation of patients to the first and second clinics—did involve what was in fact a randomization, though this was not realised at the time. This article begins by explaining why Semmelweis’s methodology, nevertheless, did not amount to the use of a RCT. It then shows why it is descriptively and normatively interesting to compare what he did with the modern approach using RCTs. The argumentation centres on causal inferences and the contrast between Semmelweis’s causal concept and that deployed by many advocates of RCTs. It is argued that Semmelweis’s approach has implications for matters of explanation and medical practice.

KW - intervention study

KW - randomized controlled trial

KW - internal validity

KW - external validity

KW - cause

KW - Semmelweis

KW - ontology

U2 - 10.1016/j.shpsc.2009.06.003

DO - 10.1016/j.shpsc.2009.06.003

M3 - Article

C2 - 19720328

VL - 40

SP - 204

EP - 209

JO - Studies in History and Philosophy of Science Part C :Studies in History and Philosophy of Biological and Biomedical Sciences

JF - Studies in History and Philosophy of Science Part C :Studies in History and Philosophy of Biological and Biomedical Sciences

SN - 1369-8486

IS - 3

ER -