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Bodies in FluxScientific Methods for Negotiating Medical Uncertainty$
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Christa Teston

Print publication date: 2017

Print ISBN-13: 9780226450520

Published to Chicago Scholarship Online: September 2017

DOI: 10.7208/chicago/9780226450834.001.0001

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Assessing Evidence

Assessing Evidence

(p.60) 3. Assessing Evidence
Bodies in Flux

Christa Teston

University of Chicago Press

During FDA hearings, participants deliberate about the risks and benefits associated with new pharmaceutical interventions. But when drugs are on trial, competing evidences collide. To unearth how deliberators from a wide range of stakeholder positions (e.g. patients, medical doctors, insurance companies, pharmaceutical companies) navigate the complexity caused by competing evidences, this chapter uses grounded theory methodology to analyze transcripts from nineteen FDA pharmaceutical hearings. Results suggest that deliberators rely on inferential statistical analyses to resolve conundrums associated with having to assess many and multiple forms of evidence. That is, in order to make inferences about how larger patient populations will be effected by a particular drug, deliberators quantify and assess the risk-benefit ratio of a much smaller sample patient population. A chain of enthymematic, statistical premises aid deliberators in assessing the probability that their study population’s experiences can be generalized to other patient populations. Because of their making-power, or what classical rhetoric terms “poiesis,” enthymematic premises (hazard- versus time-based measures, confidence intervals, effect size, and p values) help deliberators engage in probabilistic reasoning. The chapter concludes by arguing that evidential assessment in medicine is a rhetorical practice.

Keywords:   FDA, assessment, statistics, probability, enthymeme, deliberation, poiesis, grounded theory, risk-benefit ratio

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