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Evidence-based medicine and the reconfiguration of medical knowledge.
J Health Soc Behav. 2004; 45 Suppl:177-93.JH

Abstract

Over the past decade, different parties in the health care field have developed and disseminated clinical practice guidelines as part of evidence-based medicine. These formal tools based on a scientific evaluation of the research literature purport to tell health care professionals how to practice medicine. Because clinical practice guidelines shift the knowledge base in the health care field through standardization, they remain controversial within and outside medicine. In this paper, we evaluate the predictive accuracy of four medical professionalization theories--functionalism, Freidson's theory of professional dominance, deprofessionalization theory, and the theory of countervailing powers--to account for (1) the shift from pathophysiology to epidemiology with guidelines, (2) the creation of practice guidelines, and (3) the effects of clinical practice guidelines on the autonomy of health professionals. In light of the mixed predictive record of professionalization theories, we conclude with a need for "evidence-based sociology" and a recalibration of basic premises underlying professionalization theories.

Authors+Show Affiliations

Sociology Department, Brandeis University, Waltham, MA 02454-9110, USA. Timmermans@brandeis.eduNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15779473

Citation

Timmermans, Stefan, and Emily S. Kolker. "Evidence-based Medicine and the Reconfiguration of Medical Knowledge." Journal of Health and Social Behavior, vol. 45 Suppl, 2004, pp. 177-93.
Timmermans S, Kolker ES. Evidence-based medicine and the reconfiguration of medical knowledge. J Health Soc Behav. 2004;45 Suppl:177-93.
Timmermans, S., & Kolker, E. S. (2004). Evidence-based medicine and the reconfiguration of medical knowledge. Journal of Health and Social Behavior, 45 Suppl, 177-93.
Timmermans S, Kolker ES. Evidence-based Medicine and the Reconfiguration of Medical Knowledge. J Health Soc Behav. 2004;45 Suppl:177-93. PubMed PMID: 15779473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evidence-based medicine and the reconfiguration of medical knowledge. AU - Timmermans,Stefan, AU - Kolker,Emily S, PY - 2005/3/23/pubmed PY - 2005/4/20/medline PY - 2005/3/23/entrez SP - 177 EP - 93 JF - Journal of health and social behavior JO - J Health Soc Behav VL - 45 Suppl N2 - Over the past decade, different parties in the health care field have developed and disseminated clinical practice guidelines as part of evidence-based medicine. These formal tools based on a scientific evaluation of the research literature purport to tell health care professionals how to practice medicine. Because clinical practice guidelines shift the knowledge base in the health care field through standardization, they remain controversial within and outside medicine. In this paper, we evaluate the predictive accuracy of four medical professionalization theories--functionalism, Freidson's theory of professional dominance, deprofessionalization theory, and the theory of countervailing powers--to account for (1) the shift from pathophysiology to epidemiology with guidelines, (2) the creation of practice guidelines, and (3) the effects of clinical practice guidelines on the autonomy of health professionals. In light of the mixed predictive record of professionalization theories, we conclude with a need for "evidence-based sociology" and a recalibration of basic premises underlying professionalization theories. SN - 0022-1465 UR - https://www.unboundmedicine.com/medline/citation/15779473/Evidence_based_medicine_and_the_reconfiguration_of_medical_knowledge_ DB - PRIME DP - Unbound Medicine ER -