The illusion of evidence based medicine

As it resonates with some recent posts and discussion, this opinion piece in the BMJ is probably worth pointing out…

The illusion of evidence based medicine

BMJ2022; 376 doi: (Published 16 March 2022) by Jon Jureidini and Leemon McHenry.

Here’s the opening…

The advent of evidence based medicine was a paradigm shift intended to provide a solid scientific foundation for medicine. The validity of this new paradigm, however, depends on reliable data from clinical trials, most of which are conducted by the pharmaceutical industry and reported in the names of senior academics. The release into the public domain of previously confidential pharmaceutical industry documents has given the medical community valuable insight into the degree to which industry sponsored clinical trials are misrepresented. Until this problem is corrected, evidence based medicine will remain an illusion.

Please go to the article and read the whole thing - it’s only short. The authors propse the following reforms:

  • liberation of regulators from drug company funding;

  • taxation imposed on pharmaceutical companies to allow public funding of independent trials;

  • anonymised individual patient level trial data posted, along with study protocols, on suitably accessible websites so that third parties, self-nominated or commissioned by health technology agencies, could rigorously evaluate the methodology and trial results.

The authors have a book of the same name Which I have not read (It’s been out for a few years so if anyone has had a read please let me know what you thought).