Dr Chris Kirk

Chief Executive, Biochemical Society

Medicine is a branch of science and, like all science, has to be based on the interpretation of robust evidence. We design aeroplanes with wings that can be shown to generate uplift and keep us safely in the air. By the same token, we fight malaria with drugs that have been demonstrated to disrupt the life cycle of the malarial parasite or chemicals that kill the mosquito that caries it. To treat any illness with "medicines" that cannot be shown scientifically to be effective is as immoral as sending people up in an aeroplane that is programmed to crash.

David Pollock

President, European Humanist Federation

My endorsement of EBM is part of my humanist lifestance which includes proportioning belief in any proposition to the strength of evidence for it. As W K Clifford said: “It is wrong, always, everywhere, and for anyone, to believe anything upon insufficient evidence. (W K Clifford, The Ethics of Belief)

Dinesh Bhugra

President, Royal College of Psychiatrists

The key task of any expert professional is to sift evidence and make the best judgements in managing conditions and situations. Evidence-based practice provides us with a way to do this. It allows us to use information to reach the best decisions and provide truly excellent, value-for-money services. I believe that evidence-based practice allows us to do the very best for our patients, within the resources available and in accordance with current practice.

Geoff Hanlon

President, Society for Applied Microbiology

To those of us working within the modern scientific community the idea of applying a process without fully validating it beforehand would be unthinkable. Unfortunately we have been plagued for centuries by quacks peddling unproven remedies to a vulnerable population. I have an interest in the application of novel alternatives to antibiotics for treating bacterial infections. This is particularly pertinent in the light of increasing antibiotic resistance. One approach is the use of bacteriophages (bacterial viruses), a process that emerged in the 1920s before antibiotics were available. At that time contracting a bacterial infection could easily result in death and so not surprisingly the public were ready to embrace any therapy that showed promise. Unfortunately a number of pharmaceutical companies began marketing products before the active principles of this new technology had even been established much less tested for safety and efficacy. Outrageous claims were made for the range of conditions capable of being treated most of which had nothing to do with bacteria and were simply a work of fiction. The sad fact is that bacteriophage therapy was effective and yet the erosion of confidence in the eyes of the public and the established medical community by the lack of an evidence-based approach has lasted over eight decades. Scientists now are trying to repair the damage done in the early years to establish without doubt the efficacy of the process and to properly investigate the potential of bacteriophage therapy so that, if appropriate, it may be re-introduced into the clinic.

Dr Ian Watson

President, The Association of Clinical Biochemists

Point-of-care testing is widely used and accepted, yet the evidence base for its cost/benefit is poor. There is a need to demonstrate benefit through effective outcomes as we need to recognise the substantial costs to healthcare systems associated with its widespread use.

Professor Sir John Bell

President, The Academy of Medical Sciences

The Academy of Medical Sciences’ core goal is to promote advances in medical science and to ensure these are translated as quickly as possible into benefits for society - a goal that is firmly rooted in the aims and spirit of evidence based medicine. The development of safe and effective health interventions requires an understanding of underlying physiological processes and the use of rigorous methods to test assumptions and validate results. Advances in information technology now allow large amounts of data to be systematically collected and analysed to ensure patients receive treatments based on the best possible evidence. But the evidence base is constantly evolving; patients, healthcare professionals and researchers all have a role to play in contributing to knowledge that will improve future care. We believe that academic values and the spirit of inquiry should be pervasive throughout medicine and healthcare.

Dr John Hooper

Chief Executive, Institute of Clinical Research

EBM means the appraisal of the best available evidence, which is clinically relevant data from patient-centred research. However, even the best evidence may not be suited to individual patients, clinical trials cannot include research on every type of patient, such as the elderly, women, the incapacitated, those with illnesses and minority populations, indeed a large amount of people are not represented in clinical trials. Clinincal expertise is therefore, just as important as data. We must: - Improve research to raise standards - Share knowledge by publishing all research, including individual patient cases, to avoid duplication of research - Improve clinical expertise thorugh developing professionals

Professor John Wass

Chairman, Society for Endocrinology

Evidence based medicine is fundamental to medical progress. If we take oestrogens as an example, these were originally thought to decrease heart attacks in post menopausal women. The original trials used patients whose cardiovascular risk was probably lower than average and we now know as a result of more carefully controlled trials that post menopausal oestrogens, albeit slightly, increase the risk of both breast cancer and venous thrombosis and do nothing to affect cardiovascular mortality. We have to pursue the evidence base of medicine actively and without prejudice.

Professor Peter Furness

Vice-President, The Royal College of Pathologists

When people discuss 'Evidence-based medicine' they usually mean 'Evidence-based treatment'. But what about 'Evidence-based diagnostics'? The flood of genetic information in recent years has generated many new diagnostic tests. Some are excellent; but some are based on very early results that are subsequently questioned by more detailed research. Doctors find this maze of evidence hard to follow. Members of the public, to whom these tests are often sold, probably don't even know when a test's validity has been questioned. Good evidence is crucial. But we also need good evaluation of the evidence. That means all the evidence - and nothing but the evidence.

Dr Simon Festing

Director, Research Defence Society

Evidence based... research

It should be obvious to all that modern medicine must be evidence-based. The alternative is quackery. This applies not just to clinical research, but to all the research that goes before. To produce any effective and reasonably safe medicine we must first understand the healthy body, then what goes wrong in disease, then identify targets in the body and medicines that may act on the target. And that’s just the beginning. The whole endeavour will only work if it’s based on the evidence produced at each stage of the research. That evidence must be as good as it possibly can be, whether it relies on the study of chemicals, cells, animals, humans or populations.