Luke and thread participants:
Thank your for this topic and your thoughtful translation of evidence based medicine into a design context.
Like Ken and several others, and unlike Birger, I see many parallels between design and medicine (solving problems, meeting human need/user centered). To Birger, medicine was also afloat on a sea of uncertainty once, think bleeding people and applying leaches, but thankfully less so today.
My experience is that design is ahead of medicine in user-centered research methods and practices. My experience is that design is woefully behind medicine in evaluation and knowledge built on evaluation. I don’t think your translation of medical definition caught this. This may be because medicine is so far ahead of design in developing knowledge to guide practice that in medical definition this got just a few words ”clinically relevant research, often from the basic sciences of medicine.” Medicine has a whole basic sciences foundation! It has developed many, many specific and proven measures by which to judge practice: blood pressure, blood sugar, 02 level, electrolyte balance, on and on it goes.
Design has so little guiding knowledge for practice.
It’s possible design has little guiding knowledge because design has few evaluative tools and methods to measure the effectiveness of what we design. As design moves from objects to programs, systems, and services we in design have even fewer methods and tools for evaluation. David asked for examples, this year I had a health program design project in Togo with a nice sized trial (4,000+ subjects) go partially inconclusive because of flaws in the study protocol (the control group teachers were also trained in the hygiene curriculum). This is an innovative program to help life and culture per Klaus' vision. While there is more to design than seeking evidence, evidence has a proven habit of building knowledge to guide more effective practice. My experience taught me that evidence gets harder to obtain the more you try to change systems, cultures, and societies. That doesn't make evidence less critical unless you are indifferent to the outcome of your social or cultural redesign.
A biomedical informatics colleague of mine, Dr. John Pestian - top in his field and creator/designer of a very innovative and effective system for diagnosing suicide - once said, “Truth and facts are stubborn things.” If your response is ‘whose truth and what facts’ then you won’t seek evidence-based design innovation.
Those arguing against science seem to me to be in danger of arguing against knowledge. In response to M P, from where do ideas for innovation come? Are you proposing a revelation-based epistemology where ideas pop into your head as an alternative to an experience based one where the ideas come from past experience?
We should not give up seeking evidence before we even start gathering it.
Best…
Mike Zender
stone cutter and cathedral designer
University of Cincinnati
School of Design
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