BMJ  2003;327:811 (4 October), doi:10.1136/bmj.327.7418.811

Letter

Research was evidence based

EDITOR—We appreciate Fitzmaurice's agreement with us that expert based information sources cannot be trusted.¹ We take strong issue with his notion that our research design lacks rigour and is susceptible to bias.

A careful scanning of the complete version would reveal that, although we labelled the design as a convenience sample, we actually studied the complete population of review articles meeting our criteria. We called it a convenience sample because of the difficulties identifying review articles in the grey (unindexed) literature. As outlined in the methods section, our search was not completed by us but by a medical librarian (see acknowledgement).

Once the articles were identified, each article was reviewed for content separately and independently by two researchers who were blinded to the author, institution, and journal source. As a result of pre-testing and using strict criteria, our agreement was very high. We believe this methodology represents the state of the art for this type of research.

We too wish it were true, but current research does not support Fitzmaurice's contention that most doctors evaluate research data themselves rather than relying on expert assessment. From a recent paper (just one on a long list): "The decision to initiate a new drug is heavily influenced by `who says what,' in particular the pharmaceutical industry, hospital consultants, and patients."² Unfortunately, review articles written by experts are one of the more common sources clinicians use to find out who says what.

Pinnacle Health System, 205 South Front Street, Harrisburg, PA 17104, USA ashaughnessy{at}PINNACLEHEALTH.org

University of Virginia Health System, Box 800729, Charlottesville, VA 22908, USA

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Competing interests: None declared.

References

1. Shaughnessy AF, Slawson DC. What happened to the valid POEMs? A survey of review articles on the treatment of type 2 diabetes [with commentary by D A Fitzmaurice]. BMJ 2003;327: 266-10. (2 August.)[Abstract/Free Full Text]
2. Prosser H, Almond S, Walley T. Influences on GPs' decision to prescribe new drugs—the importance of who says what. Fam Pract 2003;20: 61-8.[Abstract/Free Full Text]

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Relevant Article

What happened to the valid POEMs? A survey of review articles on the treatment of type 2 diabetes

Allen F Shaughnessy and David C Slawson
BMJ 2003 327: 266. [Abstract] [Full Text] [PDF]