Standard in azione L'evidence-based medicine tra conoscenza scientifica e pratica medica

In the last decays several authors have referred to an «audit explosion» linked to the dissemination of tools and practices based on forms of quantification of reality. One of the fields where this happened is medicine: the advent of the evidence-based approach brought standards of diagnosis and cure in medical practice, standards that set actions, therapies and exams on a probabilistic base. Starting from the literature about standards and with a theoretical framework that combines concepts from actor-network theory and economy of conventions, the paper focuses on how scientific knowledge is practiced through the use of procedural standards as clinical guidelines and therapeutic protocol. Through an ethnographic work carried out in an Oncology Department of and Italian hospital, the article will highlight how data and statistics, upon which therapeutic and diagnostic standards are based on, shape medical practices, showing how the cognitive dimension is connected with the normative one embodied in the standards. Eventually, the relationship between numbers and standards and the implication in terms of authority and inevitability in medical practice will be discussed.