Translational research

doi:10.1136/bmj.a863

Published 28 August 2008, doi:10.1136/bmj.a863
Cite this as: BMJ 2008;337:a863

Editorials

Translational research

From evidence based medicine to sustainable solutions for publichealth problems

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

Enormous efforts have been made to establish evidence basedmedicine, to protect patients from ineffective or harmful treatmentsand unjustified claims while ensuring that appropriate treatmentsare offered. A simplistic view presupposes that after treatmentsare rigorously evaluated, results are incorporated into clinicalguidelines within best practice criteria, which, in turn, informpolicies. However, the process that leads to effective sustainablesolutions to health problems is in fact non-linear, with differentforms of evidence needed at different stages by different parties.

Even the concept of scientific evidence is fairly new. Randomisedcontrolled trials only came to the fore after the discoveryof antibiotics in the 1940s.¹ For some people, the rightfuldominance of such trials in evidence hierarchies² has meantthat they form the only acceptable evidence of treatment efficacyand safety in health research. Although it is agreed that treatmentsbased on anecdotal evidence should be rejected, some vital . . . [Full text of this article]

M E J Lean, professor of human nutrition ¹, J I Mann, director ², J A Hoek, professor of marketing ³, R M Elliot, enterprise manager, life sciences ⁴, G Schofield, professor of public health ⁵

¹ Division of Developmental Medicine, Human Nutrition Section, University of Glasgow, Royal Infirmary, Glasgow G31 2ER, ² Centre for Translational Research in Chronic Disease, University of Otago, Dunedin, New Zealand (www.otago.ac.nz/ctrcd), ³ Massey University, Palmerston North, New Zealand, ⁴ University of Otago, Dunedin, New Zealand, ⁵ Centre for Physical Activity and Nutrition Research, Auckland University of Technology, Auckland, New Zealand

mej.lean@clinmed.gla.ac.uk

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