Intended for healthcare professionals


Anecdotes as evidence

BMJ 2003; 326 doi: (Published 19 June 2003) Cite this as: BMJ 2003;326:1346
  1. Jeffrey K Aronson, consultant clinical pharmacologist (
  1. Department of Clinical Pharmacology, Radcliffe Infirmary, Oxford OX2 6HE

    We need guidelines for reporting anecdotes of suspected adverse drug reactions

    “The short story” wrote William Trevor, a master of the genre, “should be an explosion of the truth.” Being interested in the clinical short stories that are anecdotal reports of adverse drug reactions and interactions, I am concerned that they should explode the whole truth.

    There are many such anecdotes. Of the 3252 citations in the 24th volume of the Side Effects of Drugs Annual,1 in which the world literature on adverse drug reactions and interactions for 2000 was critically reviewed, about a third (1075 citations) were anecdotes; in contrast, there were only 45 systematic reviews.2

    Now the hierarchy of clinical evidence emphasises large randomised controlled …

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