Views & Reviews From the Frontline

Why evidence is bad for your health

BMJ 2010; 341 doi: (Published 10 November 2010) Cite this as: BMJ 2010;341:c6368
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

Recently I spoke at a conference on implementing evidence based medicine. In particular, I asked why the robustly evidenced NHS quality and outcomes framework (QOF) has had no effect on outcomes. Is there something wrong with evidence based medicine? I opened the presentation to the floor to list the hidden weakness of “evidence.”

Commissioning bias— “No research, no evidence” is the most basic flaw of all. Drug companies are the only organisations with the resources and incentives to conduct research, so therapeutics dominate all evidence based medicine. And the industry investigates a …

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