Evidence based medicine and other stories . . .BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h405 (Published 28 January 2015) Cite this as: BMJ 2015;350:h405
Evidence based medicine defined itself as a species only about 25 years ago, but in that time it has evolved at a rate that would have astonished Charles Darwin, or even Lamarck. This is the driving metaphor in an article called “Evolution of evidence-based medicine to detect evidence mutations” (Journal of the Royal Society of Medicine 2015;108:8-10, doi:10.1177/0141076814555936). “Medicine’s evidence base evolves in many ways, sometimes in ways that can be compared to random mutations (such as adverse effects of a drug leading to investigation of its use where the effect could be beneficial) and other times through selection pressure that allows substandard evidence to flourish in ecological niches.” A delightful read.
Nowhere is the evolutionary struggle of evidence based medicine more obvious than in the matter of statins. Which one should you choose, and what are the hidden harms (if any)? The argument has become red in tooth and claw, with eminence battling with evidence …
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