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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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PRINTED FROM CHICAGO SCHOLARSHIP ONLINE (www.chicago.universitypressscholarship.com). (c) Copyright University of Chicago Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in CHSO for personal use.date: 22 October 2021

Synthesizing Evidence

Synthesizing Evidence

(p.94) 4. Synthesizing Evidence
Bodies in Flux

Christa Teston

University of Chicago Press

Medical professionals are inundated continually with new findings from clinical trials. To counter the otherwise overwhelming task of knowing how best to diagnose, treat, and prevent disease, small teams of medical professionals take responsibility for aggregating evidence from clinical trials, systematically assessing said evidence, and summarizing what they find in a single, standardized written genre called the Cochrane Systematic Review (CSR). To better understand the rhetorical labor involved in synthesizing evidence in the biomedical backstage, this chapter takes as its object of study three CSRs. Each CSR provides cancer screening recommendations for lung, prostate, and breast cancers. By mobilizes Stephen Toulmin’s model for argumentation and classical rhetoric’s stasis theory, the chapter maps each CSR’s textual features, traces reviewers’ synthesizing activity, and conducts rhetorical analyses of CSRs’ extratextual features. Findings suggest that CSR reviewers end up cutting from their syntheses more evidence than they include. Ultimately, how evidences are cut, flattened, or homogenized is a matter of methodology. Given evidence-based medicine’s methodological fetishization, the chapter concludes by proposing a novel analytic heuristic for uncovering and critiquing evidential cut-making practices. Such a heuristic may help to prevent what some critics call “conceptual cul-de-sacs” in cancer care.

Keywords:   Cochrane Systematic Review, synthesis, clinical trials, cancer screening, methodology, evidential cuts, Stephen Toulmin, stasis theory, genre, homogenize

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