Intended for healthcare professionals

Practice And Research

Comparing apples and oranges: a randomised prospective study

BMJ 2000; 321 doi: (Published 23 December 2000) Cite this as: BMJ 2000;321:1569
  1. James E Barone (drjbarone{at}, surgeon in chief
  1. Stamford Hospital, Stamford, CT 06904, USA

For many years the comparison of apples and oranges was thought to be impossible. Many authors use the analogy of the putative inability to compare apples and oranges as a means of scornfully reviewing the work of others. The titles of some recent publications 1 2 suggest an actual comparison of apples and oranges, but the authors do not, in fact, compare these two fruits. Our laboratory has been interested in this problem for many years. We attempted numerous pilot studies (unpublished data) but had not accomplished a true comparison until now. At last, successful comparison of apples and oranges has been achieved and is the subject of this report.

Methods and results

We investigated many different varieties of apples and oranges in pilot studies; for this study, however, red delicious apples were compared with navel oranges. A total of 12 objects (6 apples, 6 oranges) made up the experimental population. Measurements were performed using a standard tape measure (Pseudoscientific Instruments, Lodi, NJ). Weight was recorded to the nearest tenth of a gram using a scale. Sweetness was quantified by the Licker scale (1=kind of sweet; 2=sweet; 3=very sweet; 4=really very sweet). Statistical calculations were performed using FudgeStat (Hypercrunch Corporation, Sunnyvale, CA) on an Apple Macintosh 8500 computer (Apple Computer Inc, Cupertino, CA). No significance should be inferred from the type of computer used, nor was any bias introduced because of this. Six oranges and five apples survived the experiment. (Before the study was completed, the author's 12 year old son, Thomas, inadvertently consumed one of the objects, an apple.) Non-parametric background comparisons are shown in table 1. A striking and heretofore unappreciated similarity was noted. In only one category, that of “involvement of Johnny Appleseed,” was a statistically significant difference between the two fruits found.

Subjective findings and objective data are presented in table 2. A significant difference between apples and oranges was identified only in the categories of colour and seeds.


The study reported herein represents a breakthrough in the comparison of apples and oranges. These two fruits appear to have many features in common, as we noted differences in only three of 15 areas.

A Medline search found 52 publications unrelated to the actual study of fruit with the words “apples” and “oranges” in their titles; most are letters to the editor or editorials. Articles in the medical literature on the subject of apples and oranges are increasingly being published (see figure). Every one of these studies asserts that a comparison of apples and oranges is impossible. At first glance, some papers seemed to have addressedthe important topic of a real comparison of apples and oranges. Table 3 reveals the truth.

Table 1.

Non-parametric background fructological information

View this table:
Table 2.

Subjective and objective comparison of apples and oranges

View this table:

Incidence of “apples and oranges” in the medical literature

Table 3.

Actual subjects of selected papers purported to be comparisons of apples and oranges

View this table:

This article, certain to become the classic in the field, clearly demonstrates that apples and oranges are not only comparable; indeed they are quite similar. The admonition “Let's not compare apples with oranges” should be replaced immediately with a more appropriate expression such as “Let's not compare walnuts with elephants” or “Let's not compare tumour necrosis factor with linguini.”


  • This paper was presented in part as the presidential address at the Connecticut Society of American Board Surgeons, December 1998.

  • Funding None.

  • Competing interests None declared.


  1. 1.
  2. 2.
  3. 3.
  4. 4.
  5. 5.