Clinical epidemiology

Rather than becoming marginalized within medicine, clinical epidemiology became an “animal of medicine” (Jonathan Lomas) employed in the interests of the medical profession: “It is something that belongs to medicine and something that medicine has developed and is using in some ways to colonize the rest of health care. . . . If the blame is to be laid anywhere, it may be at the feet of the relatively thoughtful medical leaders of North America who realized that evaluation in the future for the health care system. As such, the tools of clinical epidemiology are going to be central to the policy arguments that will allow individuals to lever funds for their own particular programs and initiatives outside of governments” (Lomas, in J. Daly, 118). . . If clinical care was the soft underbelly of scientific medicine, then clinical epidemiology proved to be disciplinary armor against attacks. Not surprisingly, then, a major theme of the burgeoning critical literature on evidence-based medicine has been the identification of the ‘new paradigm’ argument of evidence-based medicine as a professional ideology” (J. Daly, 118).