04 February 2013

Evidence-based medicine should include ALL the evidence

Medicine has a dirty little secret: not all clinical trial results for drugs are reported, with positive results being “around twice as likely to get published as negative findings”, according to Dr Ben Goldacre, a medical science writer. Dr Goldacre calls this bias “a cancer at the core of evidence-based medicine” and has written a book, Bad Pharma, that addresses this widespread problem.

Evidence-based medicine (EBM) should take into account all clinical trial results, and not just cherry-pick the outcomes that match the drug manufacturer’s expectations, or quietly sweep the failed tests under the carpet. It isn’t evidence-based medicine if it doesn’t include all the evidence, even the negative ones. Those of us who criticise ‘alternative’ medicine for its lack of rigour and flawed methodology should be just as critical of similar trespasses in EBM. In fact, by claiming to be scientifically committed, EBM should be held to a higher standard of conduct.

There’s a petition calling for private and public medical researchers to publish all clinical trial results, both successes and failures, with test methods clearly described. Please sign it to show your support for evidence-based medicine that truly lives up to its name.

Here’s a TED talk by Dr Goldacre on the pernicious bias shown by drug researchers for positive clinical trial results, and why it has to stop. You will not find a more passionate, or animated, defender of proper evidence-based medicine.


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