Intended for healthcare professionals


Judging the benefits and harms of medicines

BMJ 2017; 357 doi: (Published 30 June 2017) Cite this as: BMJ 2017;357:j3129
  1. Joe Freer, editorial registrar, The BMJ,
  2. Fiona Godlee, editor in chief, The BMJ
  1. Correspondence to: J Freer jfreer{at}

Only trustworthy evidence will earn the public’s trust

How should society judge the safety and efficacy of drugs? This was the question posed by England’s chief medical officer, Sally Davies, in February 2015. Citing controversies about oseltamivir (Tamiflu) and statins, as well as growing disquiet about overmedication by doctors and conflicts of interest among researchers, she feared an erosion of public trust and asked the Academy of Medical Sciences to undertake a review.1 In June that same year, editorialists in The BMJ called on the academy to recommend “simple practical improvements that would address legitimate concerns.”2 The academy has now published its report.3 Does it deliver?

From the outset of the review, the academy confirmed that there is a problem. Its survey found that only one in three members of the public trusts the results of research. It also found that more than four fifths of general practitioners and two thirds of British adults disbelieved the results of trials funded by the drug industry.

In response to this finding, which the chair of the report, John Tooke, called “startling,”4 the academy has produced a wide ranging report that says many of the right things. But the overall result is disappointing. In their 2015 editorial, Heneghan and Goldacre warned against focusing on gaining the public’s trust through false assurances.2 They proposed instead improving the evidence base through changes in the funding, conduct, and dissemination of research. The academy report includes welcome calls for researchers to involve patients and be more transparent, but its main focus (taking up half …

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