Evidence Based Madecine
However opinions were expressed since its publication, there is
little doubt that Smith's brilliant satire is already a much-cited classic
(1,2). Comments apart, the guy that called attention for the unwittingness
of those who took it very literally and essayed about the science of RCTs
and parachuting is cristal clear right: they should read more (in general)
and more satiric writings. Smith's work is an appeal to common sense (not
the "all doctors are right" kind of common sense, but the "common sense"
kind of common sense). Besides, it is a reflection upon the limits of any
methodology when we are in search of truth. I truly liked the suggestion
by another comment that one day we shall preferably use bayesian models to
investigate health and disease, obviating the need for the "many hundred
guineans" (they are rarely aware that they must face a 'Xerxes', anyway)
in regular RCTs. My opinion for now is that, scientists or not, general
literacy and "common sense" must be better taught for doctors. I believe
that a good beginning would be the obligatory reading and interpretation
for med students of Moliere's "Le Medecin Malgre Lui"; or should it be
modernized to Le Factuelle Medecin Malgre Lui?
1. Smith G,Pell JP. Parachute use to prevent death and major trauma
related to gravitational challenge: systematic review of randomised
controlled trials. BMJ 2003;327: 1459-61.
2. Potts M, Prata N, Walsh J and Grossman A. Parachute approach to
evidence based medicine. BMJ 2006; 333:701-703.
Competing interests: No competing interests