What doesn't work and how to show it

doi:10.1136/bmj.328.7438.473

BMJ 2004;328:473 (28 February), doi:10.1136/bmj.328.7438.473

Editorial

What doesn't work and how to show it

Ineffectiveness is hard to prove and accept

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

Archie Cochrane, the British epidemiologist, posed three keyquestions to ask about a healthcare intervention: "Can it work?""Does it work in practice?" and "Is it worth it?"¹ It wouldbe great if the answers to these were always positive, but lifeisn't like that. The possible answers might be classed as "yes,""not sure," and "no." The rules for deciding "yes" are relativelyclear and well known, but less has been written about decidingthat something doesn't work. This theme issue looks at examplesof interventions that don't appear to work, the dilemmas oftrying to decide between an answer of "not sure" and "no," andwhat to do when we are not sure.

Doust and Del Mar admit (p 474)² that "Don't just do something,stand there!" sounds ludicrous. But this is sometimes good advice,as their round up of commonly used but apparently ineffectiveinterventions . . . [Full text of this article]

Phil Alderson, associate director

UK Cochrane Centre, Oxford OX2 7LG (palderson@cochrane.co.uk)

Trish Groves, senior assistant editor

BMJ (tgroves@bmj.com)

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