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EGENIS seminar: The ‘First Line of Evidence’: Case Reports in Emergency Situations. Prof Rachel Ankeny (University of Adelaide)

Egenis seminar series

TDespite having a somewhat dubious reputation as a form of anecdotal evidence, case reports remain exceedingly popular forms of communication and publication in medicine. They are ill-understood even within biomedical research communities, often described as not counting as real evidence or even as equivalent to anecdotes. This paper begins by introducing the case report and its typical uses in the context of research in contemporary medicine, and exploring their status as a form of evidence particularly in our era dominated it is by ‘evidence-based medicine’ (EBM). I then flip the usual approach on its head: instead of criticizing how cases fall short of these ideals, I investigate a recent example where cases were extremely important, in order to show what cases are good for, and what it means to use them ‘well,’ including what epistemic resources need to be in place.

Event details

Case reports are particularly useful in situations where time, resources, or other practical limitations do not allow for randomized controlled trials, but especially in emergency situations. High-quality evidence remains of the utmost relevance to decisions that need to occur during such times. The recent COVID-19 pandemic provides an excellent space in which to investigate how case reporting works in practice when such activities must proceed despite considerable limitations on researchers’ abilities to conduct the usual research that is typically considered to undergird evidence-based clinical practice and public health.

In this paper (drawing on a chapter in my book manuscript on philosophy and medical case reporting), I argue that although what the philosophers of science John Dupré and Sabina Leonelli (2022) have described as ‘reification’ undoubtedly occurred during the pandemic (and must occur in any form of inquiry, as they stress), especially with regard to stablishing the entity under exploration, in their case the viral infection associated with COVID-19, case reports explicitly attempted to capture fluidity and change observed in the phenomena relating to the disease, and not embed too many assumptions within these observations. I show how these processes reflect abductive reasoning of the type espoused by the American philosopher C.S. Peirce in his later views. These arguments provide important considerations not just for those interested in medical cases or philosophy of medicine, but more generally for those seeking to provide more complex accounts of various fields of science in practice.

Registration details to follow.