BMJ 2001;322:1304 ( 26 May )

Letters

How policy informs the evidence

    Comprehensive evidence is needed in decision making
    Lessons have also been learnt in disciplines outside medicine

Comprehensive evidence is needed in decision making

The first 150 words of the full text of this article appear below.

EDITOR---Davey Smith et al have identified some problems with evidence based decision making in health care.1 Nevertheless, when these are set against the deficiencies of much current (non-evidence based) decision making, evidence based decision making still compares favourably.

Administrators, facing complex allocation choices within tight budgets, are inclined to focus on economic notions of efficiency and fair play. The rationale is: "If it's not too expensive and seems to help a disadvantaged group we might be prepared to pay for it." When people are presented with a problem (often the solution is presented first, implying that there must be a problem) they gather whatever information will confirm the merit of the intended intervention as quickly as possible. Inequalities in health are not remedied, nor the health of the population as a whole benefited, by this short term damage control.

Controlled trials are important in examining efficacy (the safety . . . [Full text of this article]
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