Critically engaging: integrating the social and the biomedical in international microbicides research.
Critically engaging: integrating the social and the biomedical in international microbicides research.
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DOI：
10.1186/1758-2652-14-s2-s4
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发表时间：
2011-09-27
影响因子：
6
通讯作者：
Pool, Robert
中科院分区：
文献类型：
--
作者：
Montgomery, Catherine M;Pool, Robert
众所周知，随机对照试验和批判性社会理论并不是快乐的伙伴。这种试验是嵌入在一个实证主义的世界观，寻求明确的答案，可测试的问题;批判社会理论的问题的方法，我们认为世界是可知的，并可能考虑在生物医学科学的实验作为社会文物。然而，这两个认识论和方法论上的分歧领域提供了潜在的重要进展，艾滋病毒的研究。在本文中，我们描述了社会和生物医学研究人员之间的合作，一个大型的，公共资助的计划，以开发阴道杀微生物剂预防艾滋病毒。在关键参与方面，在方案中整合和定性社会科学成分意味着可能在随机对照试验的核心嵌套替代认识论。社会科学研究通过展示关键行为测量的不一致性，强调了试验数据的不可靠性和脆弱性。它还突出了杀微生物剂的生物医学概念与研究凝胶在用户日常生活中的意义和用途之间的脱节。这些调查结果通过反馈回路不断传达给小组的临床和流行病学成员，通过反馈回路还可以辩论新的关切问题，并在理论上根据方案不断变化的需要调整数据收集。虽然关键的发现被实验者采纳，但证据的等级仍然限制了一些社会科学发现的效用。尽管临床流行病学家和社会科学家之间相互尊重，在管理和协调机构中有平等的代表权，不同学科的资金也是公平的。我们讨论的积极作用，社会科学融入艾滋病毒预防试验可以发挥，但仍然强调紧张局势，仍然存在的层次结构的认识论存在竞争的范式和优先事项。
Randomized controlled trials and critical social theory are known not to be happy bedfellows. Such trials are embedded in a positivist view of the world, seeking definitive answers to testable questions; critical social theory questions the methods by which we deem the world knowable and may consider experiments in the biomedical sciences as social artifacts. Yet both of these epistemologically and methodologically divergent fields offer potentially important advances in HIV research. In this paper, we describe collaboration between social and biomedical researchers on a large, publicly funded programme to develop vaginal microbicides for HIV prevention. In terms of critical engagement, having integrated and qualitative social science components in the protocol meant potentially nesting alternative epistemologies at the heart of the randomized controlled trial. The social science research highlighted the fallibility and fragility of trial data by demonstrating inconsistencies in key behavioural measurements. It also foregrounded the disjuncture between biomedical conceptions of microbicides and the meanings and uses of the study gel in the context of users' everyday lives. These findings were communicated to the clinical and epidemiological members of the team on an ongoing basis via a feedback loop, through which new issues of concern could also be debated and, in theory, data collection adjusted to the changing needs of the programme. Although critical findings were taken on board by the trialists, a hierarchy of evidence nonetheless remained that limited the utility of some social science findings. This was in spite of mutual respect between clinical epidemiologists and social scientists, equal representation in management and coordination bodies, and equity in funding for the different disciplines. We discuss the positive role that social science integrated into an HIV prevention trial can play, but nonetheless highlight tensions that remain where a hierarchy of epistemologies exists alongside competing paradigms and priorities.