Editorials

Evidence based medicine

BMJ 1995; 310 doi: http://dx.doi.org/10.1136/bmj.310.6987.1085 (Published 29 April 1995) Cite this as: BMJ 1995;310:1085
  1. Frank Davidoff,
  2. Brian Haynes,
  3. Dave Sackett,
  4. Richard Smith
  1. Editor, Annals of Internal Medicine Philadelphia, PA 19106-1572, USA
  2. Editor, Evidence Based Medicine and ACP Journal Club Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario
  3. Editor, Evidence Based Medicine Centre for Evidence Based Medicine, John Radcliffe Hospital, Oxford OX3 9DU
  4. Editor, BMJ London WC1H 9JR

    A new journal to help doctors identify the information they need

    Busy doctors have never had time to read all the journals in their disciplines. There are, for example, about 20 clinical journals in adult internal medicine that report studies of direct importance to clinical practice, and in 1992 these journals included over 6000 articles with abstracts: to keep up the dedicated doctor would need to read about 17 articles a day every day of the year.1 In earlier eras limitations in our understanding of human biology and the absence of powerful clinical research methods meant that major advances were published far less commonly than now. Consequently, clinicians' failure to keep up did not harm patients.

    Not any more. Rapid advances in physics, chemistry, and molecular biology since the second world war have led to a huge increase in the possibilities for managing patients. Effective treatments have appeared often for the first time. In parallel with these scientific advances researchers have developed methods of applied research—epitomised by the randomised controlled trial—to identify which new ideas for diagnosis, treatment, and predicting outcome actually work. Many do not and may do more harm than good.

    Doctors need to …

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