Evidence-Based Medicine Matters

Sir Iain Chalmers

Editor, James Lind Library

As far as I am concerned there should be a single standard to judge evidence across the board – orthodox and complementary/alternative.

Evidence based medicine is important to me as a patient, because that’s where I come from now. I used to be a clinician, I used to be a researcher, but I’m none of those things now. I’m a patient. By demanding an expensive treatment that might have a modest advantage over some alternative treatment, I will probably reduce treatment options open to other people using the National Health Service. In a spirit of, if you like, social solidarity, I feel that, as our National Health Service will always have a limited budget, it is proper to be thinking about the costs of treatments, and not to be blinkeredly selfish in deciding that one must have a treatment regardless of its effectiveness and cost.

All of the relevant information needs to be made available to those who are judging whether drugs should be released for us to be given them. One of the things that annoys me about some ‘scientific establishment’ statements on complementary medicine is the failure to take sufficient account of psychologically mediated effects of care and the need for more research to understand how best to exploit them. Many, perhaps most patients know that these elements of health care are important, so it’s silly to pretend they aren’t out there and in needs of consideration.