Intended for healthcare professionals


Learning from evidence based mistakes

BMJ 2004; 329 doi: (Published 28 October 2004) Cite this as: BMJ 2004;329:1053
  1. Hilda Bastian, head of department (
  1. patient information and research, Institut für Qualität und Wirtschaftlichkeit in Gesundheitswesen, Cologne, Germany

    I guess it's safe to say I'm a diehard evidence enthusiast. It's essential to get as close to the truth as you can, especially through the tangled mix of commercial and power biases that so plague health information. But if we all paid more attention to the potential adverse effects of evidence based medicine (EBM) too, maybe there would be even fewer mistakes.

    My first evidence based mistake came early in my involvement with EBM. When two of the member organisations of the consumer coalition I was involved with were set against each other because of a controversy, we did the evidence based thing. We turned to the systematic review to decide what stand we should take.

    The subject? Bromocriptine for lactation suppression. One of our member groups demanded that we support a call for a ban of the drug for this indication, while another objected just as vehemently to removal of access. The systematic review concluded that the drug was effective, with no concerning adverse effects. We didn't support the …

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