Intended for healthcare professionals

Letters Evidence based medicine is broken

Clinical guidance is not designed to replace professional judgment

BMJ 2014; 348 doi: (Published 29 January 2014) Cite this as: BMJ 2014;348:g1106
  1. David Haslam, chair1
  1. 1National Institute for Health and Care Excellence, London SW1A 2BU, UK
  1. laura.gibson{at}

Spence misses two important points in his demolition of evidence based medicine.1 The first is the misunderstanding that evidence based medicine leaves no room for discretion. This is clearly nonsense, otherwise doctors would have been replaced by robots long ago. Doctors have a responsibility to …

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