Intended for healthcare professionals

Observations History Lessons

The medical reformation

BMJ 2014; 348 doi: (Published 16 June 2014) Cite this as: BMJ 2014;348:g3963
  1. Richard Lehman, senior research fellow, department of primary healthcare, University of Oxford
  1. edgar.lehman{at}

As the old order falls apart, we must all work towards the goal of dependable, real time, patient relevant evidence, which is brought to bear through effective shared decision making

The Reformation that we know best began some time after the year 1500 but had its roots in a technological revolution that took place 50 years earlier—the invention of the printing press. But modern technology is bringing another reformation in medicine.

Then (1450-1500): Thanks to the printing press, the holy scriptures became widely available in Latin. But ordinary people could not read them, and scholars began to find that they were not very accurately translated.

Now (1990-present): Thanks to the internet, randomised controlled trials and systematic reviews are widely available, but ordinary people do not read them and scholars find many inconsistencies and gaps.

Then (1500-1520): A group of scholars (Colet, Erasmus, etc) attempted more accurate translations of the scriptures and …

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