Intended for healthcare professionals

Rapid response to:


Evidence based medicine has come a long way

BMJ 2004; 329 doi: (Published 28 October 2004) Cite this as: BMJ 2004;329:990

Rapid Response:

Evidence based medicine: old wine in new bottle?

The practice of medicine in different cultures and civilizations over
the ages has never been blind. The rationale for diagnosis and treatment
has always been based on evidence ranging from gut or spiritual feeling,
minimal anecdotal experience, to well controlled studies.

In contrast to earlier times when fewer studies were undertaken and
less proper scientific evidence was available, both the quality and volume
of current research into all aspects of medicine has multiplied
tremendously in scope and depth. This has resulted in the availability of
vast amounts of data that needs to be scrutinized, and the need to ensure
that the methodologies and the conduct of the studies themselves are

The concept of evidence based-medicine is not new. It has been with
us from the beginning of time. If something did not work, man has always
sought alternative and more effective solutions and this applies not only
to medicine but also to all aspects of human life from agriculture to
engineering. Man has based his practice on whatever evidence he could
gather, and in its absence he has resorted to what is next best – gut
feeling tempered by traditional, cultural and religious values.

The fact is that we are more scientific now than in the past, but we
would certainly be less scientific now than in the future. The only
rational action to pursue is base one’s practice on the best available
data at any one time and keep up-to-date with the new evidence that

Professor Davendralingam Sinniah

Professor of Paediatrics

Penang Medical College,
4 Jalan Sepoy Lines,
10450 Penang, Malaysia

Competing interests:
None declared

Competing interests: No competing interests

11 January 2005
Davendralingam Sinniah
Professor in paediatrics
Penang Medical College, 4 Jalan Sepoy Lines, 10450 Penang, Malaysia