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Bmj Usa: Editorial

Blowing the whistle on review articles

BMJ 2004; 328 doi: (Published 11 March 2004) Cite this as: BMJ 2004;328:E280
  1. Allen F Shaughnessy (, director of medical education,
  2. David C Slawson, B Lewis Barnett, Jr, professor of family medicine
  1. Pinnacle Health System Harrisburg, PA
  2. Department of Family Medicine University of Virginia Charlottesville, VA

    What should we know about the treatment of type 2 diabetes?

    Ask the expert.

    Whether we are trying to choose the best storm door at Home Depot or the best treatment for patients with type 2 diabetes, most of us turn to experts to help us make the decision, or, in some cases, to make the decision for us.1 Experts are easy to use, and almost by definition are not subject to questioning. After all, they are “the experts.”

    In a recent analysis of review articles on the treatment of type 2 diabetes, we found that the experts writing them often did not tell us—the readers—the most important research evidence published in the past 25 years in the treatment of patients with type 2 diabetes.2 It's time to explore the value of experts and examine our reliance—or even addiction—to the pronouncements of experts.

    The evidence—the United Kingdom Prospective Diabetes Study

    Started in 1977, the United Kingdom Prospective Diabetes Study (UKPDS) was designed to determine whether tight glycemic control decreases diabetes-related complications and increases life expectancy.3,4 A second arm of the study investigated the role of tighter control of blood pressure in patients with both diabetes and hypertension.5 …

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