BMJ  2004;328:1077 (1 May), doi:10.1136/bmj.328.7447.1077

Letter

E is for equivocal in EBM

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

EDITOR—Straus asks what's the E for EBM (evidence based medicine).¹ E is for equivocal because that's the best assessment of most published, controlled, double blind research studies (no matter the medical journal).

The evidence for EBM is inherently unreliable for four reasons.

Firstly, a large volume of research funded by drug companies is not allowed by them to be submitted for publication.^{2 3}

Secondly, totally unsuitable patients are sometimes recruited into sensitive drug trials, and only a few such patients are needed to invalidate the conclusions of studies. There is no way when doing peer reviewing or reading the paper after publication that this can be detected. I have noticed this only from reading the paper, carefully going through a patient's notes, and talking to the patient at length. I have seen this in diabetes research, but it could be common in areas of medical research because no one . . . [Full text of this article]

Rosendale Surgery, London SE21 8EZ lkiln@AOL.com

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