I was just reading the latest issue of the ACP Journal Club and I came across an interesting editorial by Dr. Iain Chalmers, founder of the Cochrane Collaboration and editor of the James Lind Library.
The James Lind Library was created to help people understand fair tests of treatments in health care by illustrating how fair tests have developed over the centuries. This is a fascinating Web site and well worth a perusal by those interested in the history of fair testing of health care treatments.
James Lind was the Scottish naval surgeon who conducted a controlled trial for treatment of scurvy, and published his A Treatise of the Scurvy in 1753. This must be one of the first systematic reviews published …Together with a Critical and Chronological View of what has been published on the subject …
Chalmers I. Why fair tests are needed: a brief history [editorial]. ACP J Club 2006; 145(1):A8-A9. [subscription required]
Excerpt: Fair tests of treatments are those that take steps to obtain reliable information about treatment effects by reducing the misleading influences of biases and the play of chance. Why do we need such tests in health care? Have not doctors, for centuries, “done their best” for their patients? Sadly, health professionals in most if not all spheres of health care have harmed their patients inadvertently, sometimes on a very wide scale, because treatment decisions were not informed by what we now consider to be reliable evidence about the effects of treatments. Indeed, patients themselves sometimes harm other patients when, on the basis of untested theories and limited personal experiences, they encourage the use of treatments that turn out to be harmful.
The question is not whom we can blame but whether we can reduce the harmful effects of inadequately tested treatments. And it seems we can-to a great extent-first, by avoiding applying untested theories about the effects of treatment in practice, and second, by wider use of fair tests of treatments.
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