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Evidence b(i)ased medicine

BMJ 2003; 326 doi: (Published 15 March 2003) Cite this as: BMJ 2003;326:602

CRAP may be sounding timely alarm

  1. Massimo Porta, associate professor of medicine (
  1. Department of Internal Medicine, University of Turin, Corso AM Dogliotti 14, I-10126 Turin, Italy
  2. George Washington University, Washington, DC 20037, USA
  3. 1112 Nicodemus Road, Reisterstown, MD 21136, USA

    EDITOR—Is the move complete from the early idealistic vision of evidence based medicine (EBM) to the earthly establishment of evidence biased medicine, complete with priests, liturgy, and inquisition? I think not, at least not yet. But the Clinicians for the Restoration of Autonomous Practice (CRAP)'s fortuitous uncovering of evidence based medicine's religious tracts in the making sounds a none too early alarm.1 Practitioners who idealistically continue to apply available evidence to medicine will increasingly have to fear the wrath of the zealots when they resort to that most lay of clinical approaches: common sense.

    Prompted by your revelations, I discovered more of evidence based medicine's dire consequences by opening the website of a regulatory agency and then playing the compact disc of an approved evidence based medicine textbook in html.

    Firstly, only corporations that can afford to punt $1bn per shot and then wait around 10-12 years to reap the benefits, if any, are allowed to develop new treatments. …

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