“There's none so blind as the double blind.” DiscussBMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7394.889 (Published 19 April 2003) Cite this as: BMJ 2003;326:889
- Anthony Seaton, chest physician (firstname.lastname@example.org)
I confess to a deep unease about therapeutic correctness and the guideline industry. While it is worthwhile knowing that a drug on average does more good than harm when tried on many thousands of patients, ultimately it is its effect on my patient that matters.
Archie Cochrane was extremely sceptical of established practice and questioned everything. The first thing he ever said to me was that he believed lateral chest radiographs were unnecessary, a point that at the time few would have agreed with. When pressed, he admitted that he couldn't interpret them, but that only a trial would convince him of their value. Fortunately I had some evidence. I like to think of him in Heaven, whisky in hand, smiling a sceptical smile as bigger and bigger studies, funded by increasingly anxious drug companies, are required to show smaller and smaller benefits. But I'm sure he is pleased at the scrutiny this initiative has brought to common intractable problems of patient management such as incontinence.
All progress depends on the sceptic
In 1906, …