Project description
Understanding the confusion in medical test evaluation
The evaluation of medical tests is currently in a state of confusion. Traditionally, diagnostic accuracy, gauged by sensitivity and specificity, has been the main measure. Sensitivity and specificity are often viewed as constants, but this assumption is contested. Some experts argue that these metrics vary significantly and should be abandoned in favour of patient outcomes, while others disagree. This confusion hampers medical practice. With the support of the Marie Skłodowska-Curie Actions programme, the HistPhilMedTest project aims to clarify this issue using historical and philosophical tools. By examining the evolution of test evaluation throughout the 20th century, the project highlights the shifting balance between assumptions of patient homogeneity and heterogeneity.
Objective
This project uses integrated history and philosophy for medicine to inform medical practice today. The evaluation of medical tests is today in a state of confusion. Traditionally, the main index used to evaluate diagnostic tests is diagnostic accuracy. Typically, this is done by evaluating the sensitivity (the proportion of patients with a disease that test positive) and the specificity (the proportion of patients without a disease who test negative) of a test. Sensitivity and specificity are commonly assumed to be constants, or to vary only in a limited rage of circumstances. In contrast to this, others claim that sensitivity and specificity are highly variable, so much so that the ‘diagnostic accuracy paradigm’ should be abandoned. Instead of focusing on diagnostic accuracy, some recommend that test evaluation should focus on patient outcomes, whilst others strongly disagree. This confusion is detrimental to medical practice, as it leaves medicine in a state of not knowing how to tell if a medical test is a good one. This project seeks to understand and address this confusion using historical and philosophical tools. Philosophical analysis reveals that the differing attitudes to test evaluation have at their root differing philosophical assumptions about how homogeneous or heterogeneous patients with the same disease are. The project provides and intellectual and social history that traces the development of test evaluation over the twentieth century. It follows how successive generations of researchers have balanced assumptions of homogeneity and heterogeneity and modified them for use in their particular setting. The central claim of this project is that understanding medical history is key to balancing assumptions of homogeneity and heterogeneity skillfully.
Fields of science (EuroSciVoc)
CORDIS classifies projects with EuroSciVoc, a multilingual taxonomy of fields of science, through a semi-automatic process based on NLP techniques.
CORDIS classifies projects with EuroSciVoc, a multilingual taxonomy of fields of science, through a semi-automatic process based on NLP techniques.
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Programme(s)
- HORIZON.1.2 - Marie Skłodowska-Curie Actions (MSCA) Main Programme
Funding Scheme
HORIZON-TMA-MSCA-PF-EF - HORIZON TMA MSCA Postdoctoral Fellowships - European FellowshipsCoordinator
40225 Dusseldorf
Germany