Evidence-based decision-making: an argumentative approach

A practical theory of argumentation is outlined and applied to a hypothetical clinical scenario to elucidate the use of research evidence in individual treatment decisions. The primary role of research evidence is to establish warrants as opposed to warrant using. Warrants are defined as the rules, principles or interpretive rationales used to justify an inference from observed data to conclusion, or clinical claim. Clarity on the appropriate use of research evidence in clinical decision-making can help resolve current debates over the nature and consequences of evidence-based medicine. The theory of argumentation has potential to inform both the design of decision support tools and to provide criteria for assessing decisional performance. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.