BMJ  2003;327:345 (9 August), doi:10.1136/bmj.327.7410.345-a

Letter

On abandoning ties and avoiding nose rings

Medical humour has implications for evidence based medicine...

EDITOR—Every year the BMJ and Medical Journal of Australia use their Christmas edition to inject some medical humour into the normally serious scientific literature. In this spirit we put together a fictional study entitled "Evidence based physicians' dressing: a cross-over trial,"¹ in which we documented the effect of "retro" dress (flared jeans, Hawaiian shirts, moussed hair, and nose rings) on patients' confidence.

Tongue in cheek, we described the Kolmogorov-Smirnoff test as two statisticians eyeballing the data over a glass of vodka, and we created a "fashion-operator characteristic" curve which defined a zone of "fashion limbo." We also calculated a number needed to dress (NND), analogous to the number needed to treat (NNT).

Despite what we and others saw as the obvious lightheartedness of this story, it has been reported as a serious research finding by the BBC² and now the BMJ,³ both with a commentary from a medical expert.

We are both amused and alarmed by these occurrences and have been puzzling about their interpretation. Is this a sad commentary on:

• The sense of humour (or lack of it) in the medical scientific community?
  
• How thoroughly news media check their sources?
  
• The state of evidence based medicine? Does writing up something as a randomised trial give it such credence that it overrides common sense?
  
• How people read articles? Is an abstract sufficient to create the perception of veracity?
  

We wish to set the record straight that this was a fictional study and was simply intended to be, and was labelled as, medical humour. From the amount of interest it has generated it may be a fertile area for real research.

John Hunter Hospital, University of Newcastle, Level 3, David Maddison Building, Newcastle, New South Wales 2300, Australia john.attia{at}newcastle.edu.au

John Hunter Hospital, New Lambton, New South Wales 2305, Australia

---

Competing interests: None declared.

References

1. Nair BR, Attia JR, Mears SR, Hitchcock KI. Evidence-based physicians' dressing: a cross-over trial. Med J Aust 2002;177: 681-2.[Medline]
2. BBC News Online. Patients like "smartly dressed doctors." http:\news.bbc.co.uk/2/hi/health/2667851.stm (accessed 27 Jul 2003).
3. Dobson R. Doctors should abandon ties and avoid nose rings. BMJ 2003;326: 1231. (5 June.)[Free Full Text]

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