Intended for healthcare professionals

Letters Evidence based medicine manifesto

Recommendations are made in the absence of any good treatments

BMJ 2017; 358 doi: (Published 30 August 2017) Cite this as: BMJ 2017;358:j3975
  1. David Colquhoun, research professor
  1. University College London, London WC1E 6BT, UK
  1. d.colquhoun{at}

Heneghan and colleagues discuss the need for better clinical guidelines.1 One problem with guidelines is that in very many cases no good treatment exists, yet recommendations are still made.

A good example is non-specific low back pain—the 2009 guidelines from the National Institute for Health and Care …

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