[Cognition-based medicine from the viewpoint of evidence-based medicine].
The anthroposophic medicine plays a prominent role among the special forms of therapy. The concept of a cognition-based medicine (CBM)--in critical analogy to the evidence-based medicine (EBM)--has emerged from the circle of promoters of this type of therapy. The present paper attempts to identify common and different features of EBM and CBM. Criticisms of CBM to EBM are presented and addressed. The central aspect of the CBM concept is the single-case recognition, in analogy to the early gestalt-psychological considerations of Dunckers in the nineteen-thirties. The EBM can certainly accept the critical relevance and justification of this concept, particularly with regard to the constantly educational (self)evaluation of the clinical decision. Individual causal recognition, on the other hand, is unable to replace the summatory evaluation of controlled studies. In certain single cases, the CBM makes "evident" the effect of a given therapy, on the other hand it is unable to establish a generally valid efficacy, which is so critical for the orientation of patients, physicians, and the socially-based healthcare system.
Raspe
Heiner
H
Institut für Sozialmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck. heiner.raspe@sozmed.uni-luebeck.de
D015510:Clinical Medicine / Q000592:standards*; D003071:Cognition; D004502:Education, Medical, Continuing; D019317:Evidence-Based Medicine / Q000592:standards*; D006801:Humans; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results