Feature Evidence Based Medicine

Why we can’t trust clinical guidelines

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3830 (Published 14 June 2013) Cite this as: BMJ 2013;346:f3830

Re: Why we can’t trust clinical guidelines

Lenzer’s concerns about the doubtful origins of clinical guidelines have encouraged an interesting debate.

The only surprise is that anyone should see fit to criticise her contribution.

It is more than four years since a respected editor of the NEJM expressed a similar point of view.

Marcia Angell wrote, “ It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgement of trusted physicians or authoritative medical guidelines.
 I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” (1)

At least three times in recent years, Angell’s comment has been quoted in Rapid Responses, without evoking interest from readers, nor from the editorial team.

Make of that, what you will.

1 Angell M, New York Review of Books, January 19, 2009.

2 www.bmj.com/rapid-response/2011/11/02/reasonable-debate

3 www.bmj.com/rapid-response/2011/11/03/renaivety-no-excuse

4 www.bmj.com/content/346/bmj.f777/rr/630449

Competing interests: No competing interests

05 July 2013
Noel Thomas
retd GP
Maesteg, Wales CF34
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